Effects of terlipressin and somatostatin on liver and thorax blood volumes in patients with cirrhosis (Journal article)

Kalambokis, G./ Tsiouris, S./ Tsianos, E. V./ Baltayiannis, G./ Pakou, B./ Fotopoulos, A.

BACKGROUND: Variceal bleeding in cirrhosis can cause liver ischaemia and deteriorate the hyperdynamic state; thus, the effects of vasoconstrictor therapy on liver blood volume (LBV) and thorax blood volume (ThBV) are important. AIM: To evaluate and compare the effects of terlipressin and somatostatin on LBV and ThBV in stable patients with cirrhosis and portal hypertension. METHODS: Twenty patients were studied (Child-Pugh class A/B/C: 5/8/7). The radioactivities in the liver region (LRR) and the thorax region (ThRR) by single-head gamma camera technique, as indicators of LBV and ThBV, respectively, and systemic haemodynamics were measured at baseline and after intravenous infusion of 2 mg of terlipressin (n=10) or somatostatin 250 mg/h after an initial bolus of 250 mg (n=10). RESULTS: LRR and ThRR decreased significantly with increasing severity of cirrhosis. Thirty minutes after terlipressin infusion, LRR and ThRR increased by 7.8 +/- 4.4% (NS) and 14 +/- 5.3% (P=0.01) compared with baseline values; the increase in ThRR was significantly related to the increase in LRR (r=0.682, P=0.03). In contrast, somatostatin reduced LRR and ThRR by 13.3 +/- 6.5% (P=0.07) and 1 +/- 4% (NS) respectively. LRR and ThRR increased significantly in the terlipressin group compared with the somatostatin group (P=0.01 and P=0.02 respectively). Terlipressin reduced cardiac output and heart rate (both P=0.01) and increased the mean arterial pressure (MAP) and systemic vascular resistance (P=0.009 and P=0.002 respectively); MAP decreased after somatostatin infusion (P=0.03). CONCLUSIONS: Terlipressin, but not somatostatin, maintains LBV, increases ThBV and improves the hyperdynamic state in cirrhosis. These effects can be beneficial in variceal bleeding, particularly in patients with advanced liver disease.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Esophageal and Gastric Varices/drug therapy/etiology/physiopathology,Female,Gamma Cameras,Hemodynamics/drug effects,Hormones/*therapeutic use,Humans,Hypertension, Portal/complications/drug therapy/physiopathology,Infusions, Intravenous,Liver Circulation/*drug effects,Liver Cirrhosis/complications/*drug therapy/physiopathology,Lypressin/*analogs & derivatives/therapeutic use,Male,Middle Aged,Radiopharmaceuticals/diagnostic use,Somatostatin/*therapeutic use,Technetium Tc 99m Sestamibi/diagnostic use,Thorax/*blood supply/radionuclide imaging,Vasoconstrictor Agents/*therapeutic use
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/22041
ISSN: 1478-3231
Link: http://www.ncbi.nlm.nih.gov/pubmed/20738780
http://onlinelibrary.wiley.com/store/10.1111/j.1478-3231.2010.02322.x/asset/j.1478-3231.2010.02322.x.pdf?v=1&t=h0ulxvka&s=4e5a272cc1b41389924c2d613433097c3ef15e36
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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