Iloprost enhances portal flow velocity and volume in patients with systemic sclerosis.
BACKGROUND
Iloprost, a prostacyclin analog, reduces hepatic microcirculatory damage after ischemia-reperfusion injury in animal liver models. The objective of this study was to evaluate whether the portal flow velocity changes after Iloprost infusion in patients with systemic sclerosis and Raynaud's phenomenon, who usually have increased risk of microvascular thrombosis and transient liver disturbances.


METHODS
Fifteen patients (3 males and 12 females, median age 58 years, range 47-66 years), with systemic sclerosis and Raynaud's phenomenon, were exclusively treated with an infusion of Iloprost (2 ng/kg/min, 6 h/day) for 5 days. In each subject, the portal flow velocity (PV, cm/sec) and portal flow volume (PFV, mL/min) were obtained by using portal color Doppler ultrasonography equipment.


RESULTS
Iloprost administration significantly (p<0.001) increased both the PV (23.6+/-3.4 cmlsec vs. 29.1+/-3.9 cm/sec) and PFV (1748.8+/-310. 7 mL/min vs. 2254.9+/-404.1 mL/min) values.


CONCLUSIONS
Hepatic perfusion significantly improved after Iloprost administration, suggesting that such treatment might be useful in preventing vascular complications in patients with systemic sclerosis. Iloprost improves the portal hemodynamics, favoring local microvascular patency, and its effectiveness may be safely monitored by using portal color Doppler ultrasonography.
Zardi
Enrico Maria
EM
Interdisciplinary Center for Biomedical Research (CIR), Laboratory of Internal Medicine and Hepatology and Campus Bio-Medico University, School of Medicine, 00155 Roma, Italy.
Picardi
Antonio
A
Ambrosino
Giovanni
G
Fazio
Vito Michele
VM
Dobrina
Aldo
A
Frego
Mauro
M
Afeltra
Antonella
A
Lumachi
Franco
F
D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D016285:Iloprost / Q000494:pharmacology* / Q000627:therapeutic use; D008102:Liver Circulation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging / Q000187:drug effects*; D011928:Raynaud Disease / Q000150:complications*; D012039:Regional Blood Flow / Q000187:drug effects; D012595:Scleroderma, Systemic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology*; D018615:Ultrasonography, Doppler, Color; D014665:Vasodilator Agents / Q000494:pharmacology* / Q000627:therapeutic use
D014665:Vasodilator Agents; D016285:Iloprost