Pe lângă modificările structurale şi funcţionale hepatice regăsite în ciroza hepatică, abordările patogenice actuale au demonstrat o implicare iniţială a structurilor vasculare hepatice. Disfuncţia endotelială are drept consecinţă alterarea tonusului vascular, creşterea rezistenţei vasculare intrahepatice şi dezvoltarea unei circulaţii hiperdinamice.S-au studiat 80 pacienţi cu ciroză hepatică clasa Child –Pugh A, B şi C. S-a constatat că valorile ET-1 au fost crescute semnificativ la pacienţii cu CH clasa Child-Pugh C, cea ce confirmă că factorii vasoconstrictori derivaţi din endoteliu sunt substanţele vasoactive secretate de endoteliul vascular hepatic ca răspuns la stimuli umorali şi biomecanici care afectează atât funcţia, cât şi structura ficatului.

Among structural and functional changes of the liver in portal hypertension, recent pathogenic approaches show an initial involvement of the hepatic vascular structures. Endothelial dysfunction results in impaired vascular tone, increased intrahepatic vascular resistance and development of hyperdinamic circulation. Endotelin-1 level in plasma was evaluated in 80 adult patients with liver cirrhosis and was elevated in patients with Child-Pugh C cirrhosis and clearly reflects endothelial dysfunction. Endothelial-derived contracting factors are powerful vasoactive substances released from the endothelium in response to both humoral and mechanical stimuli that can profoundly affect the function and the structure of the liver.