| Increased sympathetic nervous activity and the effects of its inhibition with clonidine in alcoholic cirrhosis. | |
| | |
MedLine Citation:
|
PMID: 1739234 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To study disturbances in sympathetic nervous system function in patients with alcoholic cirrhosis and the effect of clonidine on such disturbances. DESIGN: Cross-sectional physiologic and neurochemical evaluation of patients with cirrhosis and of healthy controls; an uncontrolled trial of intravenous clonidine in the cirrhotic patients. PATIENTS: Forty-four hospitalized patients with biopsy-proven alcoholic cirrhosis and 31 healthy controls. INTERVENTIONS: Intravenous clonidine. MAIN OUTCOME MEASURES: Radiotracer-derived measures of norepinephrine release to plasma, central hemodynamics, wedge hepatic vein pressure, and measures of renal function. MAIN RESULTS: In patients with cirrhosis, clonidine reduced previously elevated norepinephrine overflow rates for the whole body, kidneys, and hepatomesenteric circulation. This sympathetic inhibition was accompanied by the following potentially clinically beneficial effects: the lowering of renal vascular resistance (median reduction, 24%; 95% CI, 14% to 31%), the elevation of glomerular filtration rate (median increase, 27%; CI, 14% to 39%), and the reduction of portal venous pressure (median reduction, 25%; CI, 18% to 32%). The norepinephrine and hemodynamic responses to graded clonidine dosing (1, 2, and 3 micrograms/kg body weight intravenously) indicated that the sympathetic outflow to the hepatomesenteric circulation was more sensitive to pharmacologic suppression with clonidine than was the sympathetic outflow to the systemic circulation. CONCLUSIONS: The sympathetic nerves to the kidneys, heart, and hepatomesenteric circulation are stimulated in patients with cirrhosis. Clonidine inhibits these activated sympathetic outflows differentially, which could possibly provide a basis for the selective pharmacologic treatment of portal hypertension in patients with cirrhosis. |
| | |
Authors:
|
M Esler; F Dudley; G Jennings; H Debinski; G Lambert; P Jones; B Crotty; J Colman; I Willett |
Related Documents
:
|
4042114 - Effect of clonidine and naloxone on the pressor response during contraction of cat hind... 7490814 - Intracorporeal phenylephrine in the treatment of priapism. 9113184 - Low-dose intravenous clonidine in children: plasma concentrations and haemodynamic resp... 9839894 - Characterisation of the cardiovascular pharmacology of medetomidine in the horse and sh... 16966544 - Blood pressure measures and risk of total, ischemic, and hemorrhagic stroke in men. 2040904 - A comparison of the twenty-four-hour blood pressure profile in normotensive and hyperte... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Annals of internal medicine Volume: 116 ISSN: 0003-4819 ISO Abbreviation: Ann. Intern. Med. Publication Date: 1992 Mar |
Date Detail:
|
Created Date: 1992-03-16 Completed Date: 1992-03-16 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 446-55 Citation Subset: AIM; IM |
Affiliation:
|
Alfred Hospital, Prahran, Australia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Clonidine / pharmacology* Cross-Sectional Studies Female Hemodynamics / drug effects Humans Kidney / drug effects, physiopathology Liver Cirrhosis, Alcoholic / blood, physiopathology* Male Middle Aged Norepinephrine / blood Portal Vein / drug effects Sympathetic Nervous System / drug effects, physiopathology* Venous Pressure / drug effects |
| Chemical | |
Reg. No./Substance:
|
4205-90-7/Clonidine; 51-41-2/Norepinephrine |
| Comments/Corrections | |
Comment In:
|
Ann Intern Med. 1992 Mar 15;116(6):515-7
[PMID:
1739244
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The carpal tunnel syndrome: Part I.
Next Document: The natural history of electrocardiographic preexcitation in men. The Manitoba Follow-up Study.