title: Beneficial hemodynamic effects of dipyridamole on portal circulation in cirrhosis.
abstract: OBJECTIVE
  Dipyridamole is a vasodilator that inhibits the cellular uptake of adenosine, which physiologically reduces the resistance to hepatic arterial flow inside the liver. This study aims at assessing the acute effect of dipyridamole on functional liver plasma flow (measured as the extrarenal sorbitol clearance) and on the Doppler US Congestion Index of the portal vein (the ratio between the cross-sectional area of this vein and the mean velocity of portal flow), which correlates with the severity of portal hypertension.
  
  
  METHODS
  We have determined the extrarenal sorbitol clearance (14 cases) and the Congestion Index (seven cases) before and at 30, 60, and 90 min after the oral administration of 25 mg dipyridamole in patients with liver cirrhosis. We also measured the effect of dipyridamole on functional liver plasma flow in six healthy subjects.
  
  
  RESULTS
  Dipyridamole increased the extrarenal sorbitol clearance in controls (+17%, p < 0.01) and in cirrhotic patients (+15%, p < 0.01). The drug decreased the portal Congestion Index in all patients, averaging -24% (p < 0.05) 90 min after its oral administration.
  
  
  CONCLUSIONS
  This result was due both to a mean decrease of the portal sectional area and to a mean increase in portal flow velocity. In conclusion, these data suggest that dipyridamole should decrease the vascular resistance to portal flow in cirrhosis; this effect may be mediated by an adenosine-dependent vasodilation in the intrahepatic site or along the portosystemic collaterals.
authors.affiliation: Department of Internal Medicine, University of Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sansoè
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: P
authors.initials: P
authors.lastname: D'Alimonte
authors.forename: T
authors.initials: T
authors.lastname: Trenti
authors.forename: P
authors.initials: P
authors.lastname: Zoboli
authors.forename: R
authors.initials: R
authors.lastname: Romagnoli
authors.forename: E
authors.initials: E
authors.lastname: Villa
authors.forename: F
authors.initials: F
authors.lastname: Manenti
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004176:Dipyridamole / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008102:Liver Circulation / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000187:drug effects; D013012:Sorbitol / Q000493:pharmacokinetics; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D013012:Sorbitol; D004176:Dipyridamole