The effect of a long-acting somatostatin analogue on portal and systemic haemodynamics in cirrhosis.
Current interest in the pharmacological manipulation of portal pressure centres on the long-acting somatostatin analogue SMS 201-995. Nine haemodynamically stable cirrhotic patients who had previously bled from oesophageal varices had wedged and free hepatic venous pressures and cardiac index measured, using a Swan-Ganz catheter, before and at 60, 120 and 180 min after beginning a 60-min infusion of 25 microgram/h of SMS 201-995. Seven clinically similar patients had the same measurements performed without SMS 201-995. In all patients cardiac index was found to decrease and systemic vascular resistance increase at 60 min, although heart rates and arterial blood pressures were unchanged. The group given SMS 201-995 was significantly different from the control group in sustaining a fall in wedged hepatic venous pressure and trans-hepatic venous gradient at 60 min. SMS 201-995 causes a fall in portal pressure without a significant systemic haemodynamic effect.
Pringle
S D
SD
University Department of Medical Cardiology, Royal Infirmary, Glasgow, UK.
McKee
R F
RF
Garden
O J
OJ
Lorimer
A R
AR
Carter
D C
DC
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008102:Liver Circulation / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000494:pharmacology*; D011168:Portal System / Q000187:drug effects / Q000502:physiology*
D015282:Octreotide