[Studies on systemic hemodynamics and sympathetic nervous activity in portal hypertension]. 1988

K Nikkuni
Department of Surgery, Niigata University School of Medicine, Japan.

Hemodynamic study was carried out in 53 preoperative cirrhotic patients with portal hypertension and the postoperative prognosis was evaluated. In 16 cases of these patients, cardiovascular responsiveness to cold stress and 60 degrees head up tilt was measured using pneumoplethysmography and Swan-Ganz catheter. In comparison with the controls, cirrhotic patients were in significant hyperdynamic state. Mortality rate from hepatic failure within 2 years after operation was significantly high in the group characterized by higher cardiac index (CI) level exceeding 4.0 l/min/m2 combined with lesser K-ICG level lower than 0.08/min or lesser hepatic extraction rate of ICG (ER) level lower than 50%. Cardiovascular responsiveness to reflex autonomic stimulation was significantly impaired in cirrhotic patients. The reaction index to cold stress was inversely correlated to plasma noradrenaline (NA) concentration. There was a tendency that the higher the corrected wedged hepatic pressure (WHVP) was, the lower the reaction index was. There was also a correlation between NA and corrected WHVP and plasma tyrosine concentration and ER. In summary, impaired liver function and increase of portal pressure, which might induce deranged catecholamine metabolism, may play an important role in decrease in cardiovascular responsiveness to reflex autonomic stimulation in cirrhotic patients with portal hypertension.

UI MeSH Term Description Entries
D006975 Hypertension, Portal Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN. Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013564 Sympathetic Nervous System The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. Nervous System, Sympathetic,Nervous Systems, Sympathetic,Sympathetic Nervous Systems,System, Sympathetic Nervous,Systems, Sympathetic Nervous

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