title: Anemia worsens hyperdynamic circulation of patients with cirrhosis and portal hypertension.
abstract: This retrospective cohort study was aimed at investigating the effects of anemia on the hemodynamic disturbances associated with portal hypertension. In all, 202 consecutive nontreated portal-hypertensive patients referred for evaluation to our Hepatic Hemodynamic Laboratory were included. Compared to the nonanemic patients, anemic cirrhotic patients had an increased cardiac output (7.9 +/- 1.9 vs 7.1 +/- 2 liters/min, P < 0.01), and a decreased mean arterial blood pressure (82 +/- 11 vs 94 +/- 13 mm Hg, P < 0.0001) and systemic vascular resistance (838 +/- 235 vs 1102 +/- 356 dyn/sec/cm5, P < 0.0001). Similar results were obtained when Child A or Child B-C patients were analyzed separately. Multivariate logistic regression disclosed that hemoglobin concentration, in addition to age, sex azygos blood flow, and albumin concentration, was an independent factor influencing the degree of systemic vasodilation in cirrhotic portal-hypertensive patients. This study discloses that anemia worsens the hyperdynamic circulation associated with portal hypertension. Since hemoglobin concentration may change with time, this parameter should be taken into account when evaluating hemodynamics in portal-hypertensive patients.
authors.affiliation: Gastroenterology Department, Hospital Clinic i Provincial, University of Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Cirera
authors.forename: J I
authors.initials: JI
authors.lastname: Elizalde
authors.forename: J M
authors.initials: JM
authors.lastname: Piqué
authors.forename: F
authors.initials: F
authors.lastname: Feu
authors.forename: M
authors.initials: M
authors.lastname: Casadevall
authors.forename: E
authors.initials: E
authors.lastname: Goldin
authors.forename: J
authors.initials: J
authors.lastname: Terés
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: J
authors.initials: J
authors.lastname: Rodés
mesh_terms: D000450:Aldosterone / Q000097:blood; D000740:Anemia / Q000097:blood / Q000150:complications*; D001794:Blood Pressure; D001810:Blood Volume; D002302:Cardiac Output; D015331:Cohort Studies; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D014655:Vascular Resistance
chemical_list: D006454:Hemoglobins; D000450:Aldosterone; D012083:Renin