Effects of vasopressin and nicardipine on hemodynamics and liver function in patients with cirrhosis: comparison with vasopressin alone.
The effects of a combination of vasopressin and a calcium channel blocker (nicardipine) on portohepatic hemodynamics and liver function were compared with the effects of vasopressin alone in 18 patients with portal hypertension. Nine patients received 0.4 units/min of vasopressin and 9 patients received the same dose of vasopressin plus 0.3 mg/min of nicardipine for 40 min. Vasopressin plus nicardipine induced a significant reduction in both free portal venous pressure and the portal venous pressure gradient. These effects were similar to the changes with vasopressin alone (-14% vs. -16% in free portal venous pressure; -29% vs. -31% in portal venous pressure gradient). Vasopressin decreased both hepatic blood flow (-34%, P < 0.01) and intrinsic clearance of indocyanine green (-22%, P < 0.05). In contrast, these two parameters did not significantly change after vasopressin plus nicardipine (-8% and -3%, respectively). These results suggest that the addition of nicardipine improves hepatic impairment induced by vasopressin but causes no further reduction on portal pressure.
Iwao
T
T
Second Department of Medicine, Kurume University School of Medicine, Japan.
Toyonaga
A
A
Ikegami
M
M
Oho
K
K
Sumino
M
M
Sakaki
M
M
Shigemori
H
H
Nakayama
M
M
Sasaki
E
E
Tanikawa
K
K
D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000209:etiology; D008099:Liver / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000009:adverse effects / Q000494:pharmacology*; D013152:Splanchnic Circulation / Q000187:drug effects; D014667:Vasopressins / Q000009:adverse effects / Q000494:pharmacology*
D014667:Vasopressins; D009529:Nicardipine