Document Detail

The hemodynamic status of preascitic cirrhosis: an evaluation under steady-state conditions and after postural change.
MedLine Citation:
PMID:  1386333     Owner:  NLM     Status:  MEDLINE    
To assess the hemodynamic status of patients with compensated cirrhosis, mean arterial pressure, cardiac index and peripheral vascular resistance and markers of central (plasma concentrations of atrial natriuretic factor) and arterial volemia (plasma norepinephrine concentration, plasma renin activity) were studied in 10 patients and 10 healthy control subjects under steady-state conditions (after 2 hr of standing) and after assumption of the supine position (30, 60, and 120 min). After standing, neither hemodynamics nor markers of effective volemia differed significantly between controls and patients. By evaluating the areas under the curve during the 2 hr of supine posture, the increase in cardiac output and plasma natriuretic factor and the decrease in peripheral vascular resistance were greater in patients (2.59 +/- 0.43 [S.E.M.] L/min/hr; 32.8 +/- 7.2 pg/ml/hr -1,103 +/- 248.4 dyn.sec/cm5/hr, respectively) than in controls (0.53 +/- 0.24 L/min/hr, p = 0.005; 17.4 +/- 4.7 pg/ml/hr, p = 0.005; -265.5 +/- 206.2 dyn.sec/cm5/hr, p = 0.02). The declines in heart rate, plasma norepinephrine concentration and plasma renin activity did not differ significantly. Mean arterial pressure did not significantly change. Our results suggest that during periods of upright posture, cirrhotic patients in the preascitic stage, who are known to have expanded blood volume, compensate for dilatation of the splanchnic vascular bed through total hypervolemia. The latter becomes excessive during recumbency, leading to supernormal increases in venous return, central volemia and cardiac index. The decline in peripheral vascular resistance appears to be a compensatory mechanism to maintain steady arterial blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
M Bernardi; C Di Marco; F Trevisani; C De Collibus; L Fornalé; M Baraldini; P Andreone; C Cursaro; F Zacá; A Ligabue
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  16     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-02     Completed Date:  1992-09-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  341-6     Citation Subset:  IM    
Patologia Speciale Medica I, University of Bologna, Italy.
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MeSH Terms
Atrial Natriuretic Factor / blood
Liver Cirrhosis / physiopathology*
Norepinephrine / blood
Renin / blood
Reg. No./Substance:
51-41-2/Norepinephrine; 85637-73-6/Atrial Natriuretic Factor; EC

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