Document Detail


Systemic hemodynamic, forearm vascular, renal, and humoral responses to sustained cardiopulmonary baroreceptor deactivation in well-compensated cirrhosis.
MedLine Citation:
PMID:  7875669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to assess baroreceptor function in well-compensated cirrhosis by determining the forearm vascular, renal, and humoral responses to sustained baroreceptor deactivation. The effect of sodium status on baroreceptor function was also assessed. Eight cirrhotic patients and 10 age- and sex-matched controls were studied twice after a 20 mmol and 200 mmol of sodium/d diet for 7 days. Systemic and renal hemodynamics, renal sodium handling, forearm blood flow, and neurohumoral factors were assessed before, during, and after the application of lower body negative pressure (LBNP) for 1 hour. Controls and cirrhotic patients had similar baseline mean arterial pressure, heart rate, forearm and renal hemodynamics. High-sodium intake resulted in suppression of sympathetic nervous activity in the controls (plasma norepinephrine, 1.06 +/- 0.11 nmol/L on low vs. 0.76 +/- 0.08 nmol/L on high sodium; P = 0.01) but not in the cirrhotic patients (1.35 +/- 0.22 nmol/L on low vs. 1.26 +/- 0.11 nmol/L on high sodium; P > 0.05). Both groups responded to LBNP with significant further increases in plasma norepinephrine, resulting in significant decreases in forearm blood flow on both sodium diets. Controls also responded with a significant worsening of renal hemodynamics on low-sodium diet only, but this was not observed in the cirrhotic patients on either diet. Therefore, in well-compensated cirrhotic patients: (1) sympathetic activation occurs despite an adequate, effective arterial filling, and this may contribute to sodium retention; and (2) baroreceptor function is normal. Apparent end organ unresponsiveness within the renal circulation may account for the lack of renal hemodynamic changes to reflex sympathetic stimulation.
Authors:
F Wong; A Logan; L Blendis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  21     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-04     Completed Date:  1995-04-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  717-24     Citation Subset:  IM; S    
Affiliation:
Department of Medicine, Toronto Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Vessels / physiopathology
Diet, Sodium-Restricted
Forearm / blood supply*
Heart Conduction System / physiopathology
Hemodynamics*
Hormones / blood*
Humans
Kidney / physiopathology*
Liver Cirrhosis / physiopathology*
Lower Body Negative Pressure
Lung / innervation
Male
Middle Aged
Pressoreceptors / physiopathology*
Chemical
Reg. No./Substance:
0/Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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