Effect of verapamil on portal and splanchnic hemodynamics in patients with advanced posthepatitic cirrhosis using duplex Doppler ultrasound.
OBJECTIVE
To assess the effect of verapamil (80 mg) oral administration on portal and splanchnic hemodynamics in patients with advanced posthepatitic cirrhosis using duplex Doppler ultrasound (US).


METHODS
Fourteen patients with post-hepatitic liver cirrhosis were included in the study. Duplex Doppler sonographic examinations were performed before, and 2-3 h after, 80 mg verapamil oral administration. Portal and splanchnic hemodynamics including vessel diameters (mm), mean flow velocities (cm/s), blood flows (ml/min), Doppler indices such as pulsatility and resistive indices (PI and RI), were investigated before and after verapamil administration.


RESULTS
After verapamil administration; diameter of portal vein, splenic vein, and superior mesenteric artery (SMA) showed increase of 8%, 10%, and 7% (P < 0.05 to < 0.001), respectively. Increases of 20%, 38%, and 47% were found in blood flows (P < 0.05 to < 0.0001) with respect to the above vessels. Decreases of 17%, 10%, 11%, and 7% were found in SMA PI, SMA RI, splenic artery (SA) PI, and SA RI, respectively (P < 0.05 to < 0.0001).


CONCLUSIONS
Verapamil appears to have splanchnic, portal, splenic, portocollateral and probably intrahepatic vasodilator effects in patients with advanced posthepatitic liver cirrhosis. Verapamil should be further investigated in the treatment of patients with advanced liver cirrhosis with prospective studies measuring portal and wedged hepatic pressure.
Dinç
H
H
KTU Medical Faculty, Department of Radiology, Trabzon, Turkey.
Kapicioğlu
S
S
Cihanyurdu
N
N
Can
G
G
Unal
M
M
Topkaya
L
L
Gümele
H R
HR
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D003097:Collateral Circulation / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008102:Liver Circulation / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000187:drug effects; D008875:Middle Aged; D011169:Portal Vein / Q000187:drug effects; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects; D012039:Regional Blood Flow / Q000187:drug effects; D013152:Splanchnic Circulation / Q000187:drug effects*; D013154:Spleen / Q000098:blood supply / Q000000981:diagnostic imaging; D013162:Splenic Vein / Q000187:drug effects; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents; D014700:Verapamil