Response of blood flow to vasopressin in the collateral left gastric vein in patients with portal hypertension.

Abstract

BACKGROUND/AIMS:

A problem in pharmacotherapy for bleeding varices in portal hypertension is non-responders. The aim of this study was to elucidate the features of hemodynamic response to vasopressin in the gastroesophageal collateral vein in patients with esophageal varices.

METHODS:

Flow velocity in the portal and the collateral left gastric vein was measured with an echo-Doppler flowmeter before and during infusion of vasopressin, 0.2 U/min, in 41 patients with cirrhosis and esophageal varices.

RESULTS:

The decrease in flow velocity in the left gastric vein with vasopressin (-29 +/- 25%) was significantly smaller than that in the portal vein (-56 +/- 20%). There was no or only minimal change in flow velocity in the left gastric vein in 39% of the patients, especially in those with large-size varices. In 28 patients examined by portal catheterization, changes in flow velocity in the left gastric vein were correlated with portal pressure, and portal pressure in non-responders was significantly higher than that in responders (non-responders: 363 +/- 49, responders: 312 +/- 41 mmH2O, p < 0.05).

CONCLUSIONS:

It was concluded that hepatofugal blood flow in the gastroesophageal collateral is not readily reduced by vasopressin. However, as the study was performed in a stable condition without variceal bleeding, whether these hemodynamic features will apply during acute variceal bleeding in patients who are known to have a poor hemodynamic response to vasopressin remains to be elucidated.

• Authors: S Matsutani, H Mizumoto, T Fukuzawa, M Ohto, K Okuda
• Journal: Journal of hepatology (J Hepatol) Vol. 23 Issue 5 Pg. 557-62 (Nov 1995) ISSN: 0168-8278 [Print] Netherlands
• PMID: 8583144 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hemostatics
• Vasopressins

Topics

• Aged
• Blood Flow Velocity
• Collateral Circulation (drug effects)
• Esophageal and Gastric Varices (complications, diagnostic imaging, drug therapy, physiopathology)
• Female
• Gastrointestinal Hemorrhage (diagnostic imaging, drug therapy, physiopathology)
• Hemodynamics (drug effects)
• Hemostatics (therapeutic use)
• Humans
• Hypertension, Portal (complications, diagnostic imaging, drug therapy, physiopathology)
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Retrospective Studies
• Stomach (blood supply)
• Ultrasonography, Doppler, Duplex
• Ultrasonography, Doppler, Pulsed
• Vasopressins (therapeutic use)
• Veins