Hemodynamic effects of a prostacyclin analog (Prostavasin) in systemic scleroderma patients.
OBJECTIVE
We examined the effects of a prostacyclin analogue (Prostavasin) on the circulation of upper extremity, cerebral, ocular and visceral districts such as portal vein, hepatic artery, superior mesenteric artery, and interlobar renal artery in scleroderma patients.


METHODS
peripheral vasculature was evaluated by the brachial artery flow-mediated dilatation by the high resolution ultrasound cross-sectional measurement, splenic arterial pulsatility index (PI) resistance index (RI) of the middle cerebral artery, the central retinal artery, the visceral arteries and the portal vein flow were assessed by colour Doppler sonography in an experimental group (EG) of 50 scleroderma patients, not affected by cerebrovascular, ocular, hepatic diseases or nephropathy, before and after 3 days of Prostavasin infusion and before and after 3 days in a control group (CG) of 10 patients not receiving any treatment.


RESULTS
EG patients showed significant increasement in the brachial artery flow-mediated dilatation, in the portal vein velocity and in the splenic arterial PI (pre-Prostavasin vs post-Prostavasin treatment, p < 0.001) whereas CG patients had no significant changes. Values of the middle cerebral artery, the central retinal artery, the interlobar renal artery, the superior mesenteric artery and the hepatic artery RI were reduced after treatment in the majority of EG patients although the difference did not achieve a satisfactory statistical significance.


CONCLUSIONS
our results indicate that Prostavasin has a powerful effect in improving the peripheral circulation of scleroderma patients. Prostavasin significantly increases the portal vein flow but also the splenic arterial PI not supporting the hypothesis of its direct and specific action on relaxation of the hepatic micro circle.
Salera
Diego
D
Istituto di Radiologia, Università Politecnica delle Marche, Facoltà di Medicina, Ospedale Umberto I, Ancona.
Argalia
Giulio
G
Giuseppetti
Gian Marco
GM
D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001775:Blood Circulation / Q000187:drug effects; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003627:Data Interpretation, Statistical; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011169:Portal Vein / Q000502:physiology; D011673:Pulsatile Flow; D012161:Retinal Artery / Q000502:physiology; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D013152:Splanchnic Circulation / Q000187:drug effects; D013157:Splenic Artery / Q000502:physiology; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D014665:Vasodilator Agents; D000527:Alprostadil