Increased plasma endothelin-1 levels in patients with cirrhosis and esophageal varices.

We measured plasma levels of endothelin-1, a potent vasoconstrictor peptide, in 6 healthy controls and 20 patients with cirrhosis and correlated them with various clinical and laboratory parameters and other vasoactive substances. There was a trend toward increased endothelin-1 levels in patients with cirrhosis compared with controls (6.0 +/- 2.5 vs. 4.4 +/- 1.5 pg/ml, NS). The presence of ascites did not influence plasma endothelin-1 levels, and plasma endothelin-1 levels were not significantly correlated with serum albumin, serum bilirubin, or prothrombin time. Plasma endothelin-1 levels were significantly elevated in cirrhotic patients with esophageal varices compared with those without varices (7.5 +/- 2.5 vs. 4.5 +/- 1.6, p < 0.05). The elevation of endothelin-1 levels in patients with varices may represent a physiological compensation for the systemic vasodilation present in patients with liver cirrhosis and portal hypertension.