J.Jpn. Surg. Soc.. 89(10): 1672-1685, 1988
Original article
STUDIES ON SYSTEMIC HEMODYNAMICS AND SYMPATHETIC NERVOUS
ACTIVITY IN PORTAL HYPERTENSION
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Department of Surgery, Niigata University School of Medicine, Niigata, Japan Keiya Nikkuni |
In 16 cases of these patients, cardiovascular responsiveness to cold stress and 60° head up tilt was measured using pneumoplethysmography and Swan-Ganz catheter.
In comparison with the controls, cirrhotic patients were in significant hyperdynamic state. Mortality rate from hepatic failure within 2 years after operation was significantly high in the group characterized by higher cardiac index (CI) level exceeding 4.01/min/m2 combined with lesser K-ICG level lower than 0.08/min or lesser hepatic extractin rate of ICG (ER) level Iowelr than 50％.
Cardiovascular responsiveness to reflex autonomic stimulation was significantly impaired in cirrhotic patients. The reaction index to cold stress was inversely correlated to plasma noradrenalin (NA) concentration.
There was a tendency that the higher the corrected wedged hepatic pressure (WHVP) was, the lower the reaction index was. There was also a correlation between NA and corrected WHVP and plasma tyrosine concentration and ER.
In summary, impaired liver function and increase of portal pressure, which might induce derranged catecholamine metabolism, may play an important role in decrease in cardiovascular responsiveness to reflex autonomic stimulation in cirrhotic patients with portal hypertension.
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