Portal vein hemodynamics in cirrhotic patients with portal hypertensive gastropathy: an echo-Doppler study.
Portal hypertensive gastropathy is a major complication of cirrhosis. The aims of this study were to characterize portal vein hemodynamics and sympathetic nervous activity in cirrhotic patients with gastropathy. Forty-seven cirrhotics (mild gastropathy in 7) and 25 controls were included in this study. Portal vein hemodynamics was assessed by echo-Doppler, and sympathetic nervous activity by plasma adrenaline and noradrenaline concentrations. Portal blood flow was similar in cirrhotics and controls. However, the congestion index of the portal vein (calculated as the ratio of cross-sectional area and blood velocity) was significantly higher in the former than in the latter. Furthermore, the congestion index of the portal vein paralleled the severity of the gastropathy (ANOVA, p < 0.05). Plasma adrenaline and noradrenaline concentrations were higher in cirrhotics than in controls. However, there was no linear relationship between plasma adrenaline (ANOVA, NS) and noradrenaline (ANOVA, NS) concentrations and the severity of gastropathy. These results suggest a relative contribution of "passive congestion" in the pathogenesis of gastropathy.
Department of Medicine II, Kurume University School of Medicine, Japan.
T
T
Iwao
A
A
Toyonaga
M
M
Ikegami
M
M
Sumino
K
K
Oho
H
H
Shigemori
M
M
Sakaki
M
M
Nakayama
K
K
Tanikawa
J
J
Iwao
D000368:Aged; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016099:Endoscopy, Gastrointestinal; D004837:Epinephrine / Q000097:blood; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D013272:Stomach Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D018608:Ultrasonography, Doppler
D009638:Norepinephrine; D004837:Epinephrine