[Studies on wedged hepatic venous pressure, hemodynamics and pulmonary function in patients with chronic liver disease, with reference to the differences between liver cirrhosis with chronic hepatitis].
In 17 compensated liver cirrhosis and 8 chronic hepatitis cases (no histories of cardiac or pulmonary disease), wedged hepatic venous pressure (WHVP), hemodynamics, and pulmonary function were measured and their clinical significance and interrelations evaluated. Both diseases were comparatively analyzed. WHVP was determined by wedging a catheter from the right femoral vein into the right hepatic vein. Hemodynamics was measured with a Swan-Ganz catheter. Spirography, flow-volume curve, closing-volume curve and pulmonary diffusion capacity were measured and aortic blood gas analyzed to assess pulmonary function. Esophageal endoscopy was used to diagnose the presence or absence of esophageal varices. The results showed that the group of liver cirrhosis patients featured elevated WHVP and a hyperhemodynamic pattern and a positive correlation between WHVP on the one hand and cardiac index and right left ventricle stroke work indexes on the other; there was a negative correlation between WHVP and the systemic vascular resistance and pulmonary vascular resistance indexes. The results showed an increase in oxygen consumption in the group of patients with esophageal varices. In all chronic hepatitis cases, findings were normal. Pulmonary function was characterized by abnormal %VC, PaO2, and pulmonary diffusion capacity in both groups along with abnormal PaCO2 in the liver cirrhosis group; no significant differences were noted between the two groups. These results indicate that liver cirrhosis elevates intarahepatic pressure, affecting systemic hemodynamics and resulting in a circulatory distribution disorder, leading to right and left ventricle overload and a decline in potential cardiac function. The results also indicated that mild pulmonary function disorder can occur as early in a state of chronic hepatitis.
First Department of Internal Medicine, Nippon Medical School.
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Kurata
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Hara
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006439:Hemodynamics; D006503:Hepatic Veins / Q000503:physiopathology*; D006505:Hepatitis / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D014690:Venous Pressure