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Response of blood flow to vasopressin in the collateral left gastric vein in patients with portal hypertension.
J Hepatol. 1995 Nov; 23(5):557-62.JH

Abstract

BACKGROUND/AIMS

A problem in pharmacotherapy for bleeding varices in portal hypertension is non-responders. The aim of this study was to elucidate the features of hemodynamic response to vasopressin in the gastroesophageal collateral vein in patients with esophageal varices.

METHODS

Flow velocity in the portal and the collateral left gastric vein was measured with an echo-Doppler flowmeter before and during infusion of vasopressin, 0.2 U/min, in 41 patients with cirrhosis and esophageal varices.

RESULTS

The decrease in flow velocity in the left gastric vein with vasopressin (-29 +/- 25%) was significantly smaller than that in the portal vein (-56 +/- 20%). There was no or only minimal change in flow velocity in the left gastric vein in 39% of the patients, especially in those with large-size varices. In 28 patients examined by portal catheterization, changes in flow velocity in the left gastric vein were correlated with portal pressure, and portal pressure in non-responders was significantly higher than that in responders (non-responders: 363 +/- 49, responders: 312 +/- 41 mmH2O, p < 0.05).

CONCLUSIONS

It was concluded that hepatofugal blood flow in the gastroesophageal collateral is not readily reduced by vasopressin. However, as the study was performed in a stable condition without variceal bleeding, whether these hemodynamic features will apply during acute variceal bleeding in patients who are known to have a poor hemodynamic response to vasopressin remains to be elucidated.

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Authors+Show Affiliations

Matsutani S
First Department of Medicine, Chiba University, School of Medicine, Japan.
Mizumoto H
No affiliation info available
Fukuzawa T
No affiliation info available
Ohto M
No affiliation info available
Okuda K
No affiliation info available

MeSH

AgedBlood Flow VelocityCollateral CirculationEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHemodynamicsHemostaticsHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedRetrospective StudiesStomachUltrasonography, Doppler, DuplexUltrasonography, Doppler, PulsedVasopressinsVeins

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8583144

Citation

Matsutani, S, et al. "Response of Blood Flow to Vasopressin in the Collateral Left Gastric Vein in Patients With Portal Hypertension." Journal of Hepatology, vol. 23, no. 5, 1995, pp. 557-62.
Matsutani S, Mizumoto H, Fukuzawa T, et al. Response of blood flow to vasopressin in the collateral left gastric vein in patients with portal hypertension. J Hepatol. 1995;23(5):557-62.
Matsutani, S., Mizumoto, H., Fukuzawa, T., Ohto, M., & Okuda, K. (1995). Response of blood flow to vasopressin in the collateral left gastric vein in patients with portal hypertension. Journal of Hepatology, 23(5), 557-62.
Matsutani S, et al. Response of Blood Flow to Vasopressin in the Collateral Left Gastric Vein in Patients With Portal Hypertension. J Hepatol. 1995;23(5):557-62. PubMed PMID: 8583144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Response of blood flow to vasopressin in the collateral left gastric vein in patients with portal hypertension. AU - Matsutani,S, AU - Mizumoto,H, AU - Fukuzawa,T, AU - Ohto,M, AU - Okuda,K, PY - 1995/11/1/pubmed PY - 1995/11/1/medline PY - 1995/11/1/entrez SP - 557 EP - 62 JF - Journal of hepatology JO - J Hepatol VL - 23 IS - 5 N2 - BACKGROUND/AIMS: A problem in pharmacotherapy for bleeding varices in portal hypertension is non-responders. The aim of this study was to elucidate the features of hemodynamic response to vasopressin in the gastroesophageal collateral vein in patients with esophageal varices. METHODS: Flow velocity in the portal and the collateral left gastric vein was measured with an echo-Doppler flowmeter before and during infusion of vasopressin, 0.2 U/min, in 41 patients with cirrhosis and esophageal varices. RESULTS: The decrease in flow velocity in the left gastric vein with vasopressin (-29 +/- 25%) was significantly smaller than that in the portal vein (-56 +/- 20%). There was no or only minimal change in flow velocity in the left gastric vein in 39% of the patients, especially in those with large-size varices. In 28 patients examined by portal catheterization, changes in flow velocity in the left gastric vein were correlated with portal pressure, and portal pressure in non-responders was significantly higher than that in responders (non-responders: 363 +/- 49, responders: 312 +/- 41 mmH2O, p < 0.05). CONCLUSIONS: It was concluded that hepatofugal blood flow in the gastroesophageal collateral is not readily reduced by vasopressin. However, as the study was performed in a stable condition without variceal bleeding, whether these hemodynamic features will apply during acute variceal bleeding in patients who are known to have a poor hemodynamic response to vasopressin remains to be elucidated. SN - 0168-8278 UR - https://www.unboundmedicine.com/medline/citation/8583144/Response_of_blood_flow_to_vasopressin_in_the_collateral_left_gastric_vein_in_patients_with_portal_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/016882789580062X DB - PRIME DP - Unbound Medicine ER -