[Effects of urapidil and cimetidine on wedged hepatic venous pressure and systemic hemodynamics in cirrhotic patients with portal hypertension].
OBJECTIVE
To compare the effects of urapidil and cimetidine on portal pressure and systemic hemodynamics.


METHODS
We observed the effects of urapidil (urapidil HCl, n = 15), cimetidine (n = 20) and placebo (0.9% sodium chloride, n = 10) on wedged hepatic venous pressure (WHVP), hepatic venous pressure gradient (HVPG), and systemic hemodynamics.


RESULTS
Urapidil at a dosage of 25 mg intravenously reduced WHVP from 33.33 +/- 7.85 cm H2O to 23.75 +/- 6.83 cm H2O, the average value was 28.75% +/- 9.81% (P > 0.01); and HVPG from 21.92 +/- 2.34 cm H2O to 14.07 +/- 3.57 cm H2O, the average value was 35.81% +/- 8.71% (P < 0.01). The free hepatic venous pressure (FHVP) however was not changed significantly (P > 0.05). The heart rate was increased from 70 +/- 13 BPM to 79 +/- 21 BPM (P < 0.05), and the systolic blood pressure and the diastolic blood pressure were reduced from 122 +/- 40 mm Hg to 95 +/- 32 mm Hg and 75 +/- 17 mm Hg to 55 +/- 15 mm Hg respectively (P < 0.01). After cimetidine administered at a dosage of 400 mg intravenously, WHVP and HVPG were reduced from 34.25 +/- 7.34 cm H2O to 29.05 +/- 7.03 cm H2O and 23.14 +- 8.15 cm H2O to 17.13 +/- 4.28 cm H2O; and the average value was 15.18% +/- 8.64% and 26.00% +/- 12.19% respectively (P < 0.01). But heart rate, blood pressure and FHVP were not altered after use of cimetidine ( P > 0.05). In the control group (n = 10), WHVP, HVPG, FHVP, heart rate, as well as blood pressure were not changed after placebo treatment.


CONCLUSIONS
Both urapidil and cimetidine could reduce WHVP and HVPG significantly in cirrhotic patients with portal hypertension, and the effect of the two agents on WHVP and HVPG was not obviously different (P > 0.05). However, the systemic hemodynamic effects induced by urapidil were more significant compared with cimetidine.
Li
S
S
Department of General Surgery, People's Hospital, Beijing Medical University, China.
Feng
H
H
Zhu
J
J
Zhong
C
C
Leng
X
X
Du
R
R
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002927:Cimetidine / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000494:pharmacology; D010879:Piperazines / Q000494:pharmacology*; D014690:Venous Pressure / Q000187:drug effects*
D018377:Neurotransmitter Agents; D010879:Piperazines; D002927:Cimetidine; C015568:urapidil