Relationships between hemodynamic alterations and Child-Pugh Score in patients with cirrhosis.
OBJECTIVE
In this study, central and nonsplanchnic hemodynamic alterations in liver cirrhosis and correlation between Child-Pugh Score and these hemodynamic alterations were evaluated.


METHODS
With this aim, angiotensin-I, aldosterone, femoral blood flow, cardiac index, free water clearance and renal blood flow index were evaluated in 30 cirrhotic patients and 10 healthy control subjects.


RESULTS
Child-Pugh score was found to be directly related with serum levels of angiotensin-I and aldosterone, cardiac and renal blood flow index (r = 0.60 - p < 0.001, r = 0.57 - p < 0.01, r = 0.55 - p < 0.01 and r = 0.65 - p < 0.001 respectively), and indirectly related with free water clearance and femoral blood flow (r = 0 .72 -p < 0 .001, r = 0.71 -p < 0 .001 respectively).


CONCLUSIONS
We concluded that, in patients with cirrhosis, as the Child-Pugh score becomes greater angiotensin-I and aldosterone, cardiac output and non-splanchnic vasoconstriction progressively increase, on the other hand free water clearance and renal perfusion progressively decrease. Alterations in cardiac index and femoral artery blood flow begin before ascites formation. And the hyperdynamic circulation is a primary event independent of the central blood volume.
Dincer
Dinc
D
Division of Gastroenterology, Medical Faculty of Istanbul University of Istanbul, Turkey. ddinc@akdeniz.edu.tr
Besisk
Fatih
F
Demirkol
Onur
O
Demir
Kadir
K
Kaymakoglu
Sabahattin
S
Cakaloglu
Yilmaz
Y
Okten
Atilla
A
D000328:Adult; D000450:Aldosterone / Q000097:blood; D000803:Angiotensin I / Q000097:blood; D002302:Cardiac Output; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow
D000450:Aldosterone; D000803:Angiotensin I