Document Detail

Postprandial splanchnic haemodynamic changes in patients with liver cirrhosis and patent paraumbilical vein.
MedLine Citation:
PMID:  15618843     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The haemodynamic changes induced by a meal on collateral vessels in portal hypertensive cirrhotic patients are not well characterized. We aimed to study the postprandial modifications of splanchnic circulation in patients with a patent paraumbilical vein (PUV). METHODS: We studied 10 cirrhotic patients with patent PUV and 10 matched cirrhotic patients without PUV, by using echo colour Doppler at baseline and 15, 30 and 45 min after a standard mixed liquid meal (400 ml; 600 kcal). Calibre and blood flow velocities of the superior mesenteric artery, portal vein and PUV were obtained; congestion index of portal vein, portal blood flow, paraumbilical blood flow and effective portal liver perfusion were calculated; intrahepatic and intrasplenic arterial resistance and pulsatility indexes were recorded. RESULTS: We observed a postprandial splanchnic hyperaemia (superior mesenteric artery and portal vein blood flow increased after the meal in both groups; ANOVA P < 0.05), with no changes of hepatic impedance. In PUV patients, PUV constricted significantly postprandially, maximally at 30 min (calibre -17.5 +/- 7.0%; P = 0.003). Intrasplenic impedance, which may reflect portal pressure, increased, maximally at 30 min (pulsatility index +22.6 +/- 27.0%; P = 0.01), and inversely correlated with PUV vasoconstriction (R = 0.75, P = 0.01). In non-PUV patients intrasplenic impedance did not change. Portal liver perfusion increased similarly in both groups. CONCLUSIONS: PUV constricts after the meal, and this vasoconstriction is associated with an increase of splenic impedance which may indicate the postprandial increase of portal pressure observed in cirrhosis. The increase in postprandial portal liver perfusion in the PUV group is allowed by a paradox constriction of the collateral vessel.
Annalisa Berzigotti; Susanna Dapporto; Lucia Angeloni; Stefano Ramilli; Giampaolo Bianchi; Maria Cristina Morelli; Donatella Magalotti; Marco Zoli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  16     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-24     Completed Date:  2005-03-17     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1339-45     Citation Subset:  IM    
Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Università di Bologna, Bologna, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Analysis of Variance
Blood Flow Velocity / physiology
Collateral Circulation / physiology
Hemodynamics / physiology
Hyperemia / complications,  physiopathology
Hypertension, Portal / physiopathology
Liver Cirrhosis / complications,  drug therapy,  physiopathology*
Mesenteric Artery, Superior / physiopathology
Middle Aged
Portal Pressure / physiology
Portal System / physiopathology
Portal Vein / physiopathology
Postprandial Period / physiology*
Pulsatile Flow / physiology
Splanchnic Circulation / physiology*
Umbilical Veins / physiopathology
Reg. No./Substance:
0/Adrenergic beta-Antagonists

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