ABSTRACT
This chapter reviews the history of the cardiovascular complications of liver disease in order to “set the scene” for the rest of the volume. Portal hypertension is the major cardiovascular complication of cirrhosis. Until the beginning of the 1980s, it was considered that portal hypertension was due principally to increased resistance to flow as a result of the regeneration nodules in the liver of cirrhotic patients. Studies of hepatic blood flow in patients with alcoholic liver disease have also shown that portal blood flow is important in the pathogenesis of portal hypertension. In these patients, there is an increased portal component of hepatic blood flow, an incremental increase in portal pressure, and increased portasystemic shunting. The treatment of ascites remained problematic despite the appearance of more and more powerful diuretics which were associated with increasing renal and electrolytic complications. Moreover, patients still developed resistance.
