Octreotide blunts postprandial splanchnic hyperemia in cirrhotic patients: a double-blind randomized echo-Doppler study.
The effect of octreotide, a long-acting synthetic analog of somatostatin, on fasting and postprandial splanchnic hemodynamics was investigated in cirrhotic patients. Splanchnic hemodynamics were assessed using an echo-Doppler duplex system in a prospective, double-blind, placebo-controlled, crossover study performed on 2 separate days, 1 week apart, in 30 cirrhotic patients. Measurements of portal vein (PV) cross-sectional area (PV-A) and mean velocity (PV-V), and of superior mesenteric artery (SMA) mean velocity (SMA-V) and pulsatility index (SMA-PI) (an index of vascular resistance) were performed at baseline, 30 minutes after octreotide (200 micrograms subcutaneously) or placebo administration, and 30 and 60 minutes after the ingestion of a liquid meal. In the fasted state, octreotide induced a significant decrease in PV-V (-7%) and in SMA-V (-10%) and an increase in PI (+16%). On the day of placebo administration, meal ingestion induced a significant increase in PV-V (+21%) and in SMA-V (+43%) and a decrease in PI (-21%). In contrast, meal ingestion on octreotide day induced significantly smaller increases in PV-V (+10%) and in SMA-V (+18%) and a significantly smaller decrease in PI (-10%). Octreotide, although producing a mild reduction in PV-V and SMA-V in the fasted state, markedly blunts postprandial splanchnic hyperemia in cirrhotic patients.
Buonamico
P
P
Hepatic Hemodynamic Laboratory, Veterans Administration Medical Center, West Haven, CT 06516.
Sabbá
C
C
Garcia-Tsao
G
G
Berardi
E
E
Antonica
G
G
Ferraioli
G
G
Jensen
J E
JE
Lerner
E
E
Taylor
K J
KJ
Albano
O
O
D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D004435:Eating; D005215:Fasting; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D006940:Hyperemia / Q000188:drug therapy* / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010919:Placebos; D012212:Rheology / Q000379:methods; D013152:Splanchnic Circulation; D014463:Ultrasonography
D010919:Placebos; D005934:Glucagon; D015282:Octreotide