Effect of the somatostatin analogue lanreotide on meal-stimulated portal blood flow in patients with liver cirrhosis.
BACKGROUND
Lanreotide, a new long-acting somatostatin analogue, has been shown to inhibit the meal-stimulated increase of splanchnic blood flow in healthy volunteers. To date, similar data in patients with liver cirrhosis have not been available. We have examined the effect of lanreotide compared with placebo on meal-stimulated portal blood flow in patients with liver cirrhosis using Doppler ultrasound.


METHODS
20 cirrhotic patients (placebo n = 12, lanreotide n = 8) with proven portal hypertension were studied after an overnight fast. Lanreotide, at a dose of 100 microg/h, was infused intravenously over 7 h after a 1-hour basal period. In parallel to the intravenous infusion, a liquid test meal (Ensure plus, 1.5 kcal/min) was perfused for 7 h through an intraduodenal tube at a rate of 3 ml/min. Blood pressure, heart rate and portal vein blood flow (PVF, ml/min, Doppler technique) were determined at regular intervals.


RESULTS
Baseline PVF amounted to 725 +/- 182 ml/min in the placebo and to 917 +/- 252 ml/min in the lanreotide group (n.s.). The meal-stimulated increase in PVF was blunted by lanreotide (AUC, % x min): 62,709.6 +/- 6,817 (placebo) vs. 45,237 +/- 2,507 (lanreotide), p < 0.05. Lanreotide also blunted the postprandial increase in heart rate for the first 2 h of meal perfusion.


CONCLUSIONS
Because of potent inhibition of postprandial splanchnic hyperemia in patients with liver cirrhosis, lanreotide may be useful in the treatment of complications of portal hypertension.
Schiedermaier
Peter
P
Medizinische Klinik und Poliklinik I, Allgemeine Innere Medizin, University of Bonn, Germany. p.schneidermaier@klinikum-saarbruecken.de
Harrison
Phillip
P
Arthur
Michael
M
Grandt
Daniel
D
Sutton
Robert
R
Drewe
Jürgen
J
Larsen
Finn
F
Sieber
Cornel
C
D004311:Double-Blind Method; D005260:Female; D005502:Food; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000494:pharmacology*; D011168:Portal System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000494:pharmacology*; D018608:Ultrasonography, Doppler
D005765:Gastrointestinal Agents; D010456:Peptides, Cyclic; C060347:lanreotide; D013004:Somatostatin