Effect of terlipressin on blood volume distribution in patients with cirrhosis.
BACKGROUND
Patients with cirrhosis and portal hypertension have an altered blood volume distribution and a hyperdynamic systemic circulation. Terlipressin is known to reduce portal pressure by decreasing splanchnic inflow, but its effect on the blood volume distribution is unknown. The aim of the study was to investigate changes in regional blood volume distribution and systemic haemodynamics after administration of terlipressin to patients with cirrhosis.


METHODS
Blood volume distribution was determined in 13 patients with cirrhosis and portal hypertension by a dual-head gamma-camera technique and systemic haemodynamics was measured before and after intravenous administration of terlipressin (2 mg).


RESULTS
Terlipressin increased the blood volume in the thorax region (+6.0%, P < 0.002) and the liver region (+12.2%, P < 0.002), whereas blood volume in the splanchnic region remained unchanged. Systemic vascular resistance (SVR) and mean arterial blood pressure increased after terlipressin (+34 and +21%, P < 0.001). The increase in liver blood volume correlated directly with the increase in SVR (r = 0.88. P < 0.001).


CONCLUSIONS
Terlipressin ameliorates the hyperdynamic circulation, increases thorax and liver blood volumes, but produces no effect on the splanchnic blood volume. Besides decreasing the splanchnic inflow, terlipressin may affect portal pressure by causing vasodilatation of intrahepatic vessels.
Kiszka-Kanowitz
M
M
Dept. of Clinical Physiology, Nuclear Medicine and Gastroenterology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
Henriksen
J H
JH
Hansen
E F
EF
Møller
S
S
Bendtsen
F
F
D000328:Adult; D001810:Blood Volume / Q000187:drug effects*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology*; D008102:Liver Circulation / Q000187:drug effects*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000503:physiopathology*; D008236:Lypressin / Q000031:analogs & derivatives* / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin