Study of Plasma Cyclic Guanosine Monophosphate as a New Marker in Patients with Portal Hypertension

Abstract Background Clinically significant portal hypertension (CSPH), which causes a number of problems such variceal haemorrhage, ascites, and hepatorenal syndrome and is linked to a drastically decreased chance of survival, is a turning point in the development of liver cirrhosis. Therefore, the diagnosis of CSPH has significant prognostic significance. The measurement of the invasive hepatic venous pressure gradient (HVPG) is the gold standard for the diagnosis of portal hypertension. Objective To evaluate plasma level of cyclic guanosine monophosphate as a possible biomarker in patients with liver cirrhosis and portal hypertension Patients and Methods The type of study is a case control study; which were performed at Ain Shams university hospitals inpatients and outpatients settings for one year. The study population includes 80 patients with liver cirrhosis (40 cirrhotic patients without portal hypertension and 40 cirrhotic patients with portal hypertension 20 healthy controls). Inclusion Criteria involves adult over 18years old patients form both sexes. Results In this study we found that there was high statistically significant difference between the studied groups as regard Plasma cGMP, as level of cGMP in patients with portal hypertension is higher than in patients without portal hypertension (p < 0.001). In the present study we found that there was no statistically significant relation between Plasma cGMP and varices in patients with portal hypertension or without portal hypertension (mean 85±14.96 range:46.4-111.3, mean 82.05±20.96 range 62.5-111.3 respectively, p = 0.608). Conclusion The current investigation shows that cirrhotic patients with CSPH have dramatically disturbed plasma cGMP homeostasis. Our findings suggest that cGMP may be used as a blood- derived CSPH biomarker, particularly in the context of esophageal varices screening.