Original Articles

Digestive Diseases and Sciences

, Volume 33, Issue 9, pp 1103-1109

First online:

Hemodynamic changes of systemic, hepatic, and splenic circulation following triglycyl-lysin-vasopressin administration in alcoholic cirrhosis

  • Carlo MerkelAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Angelo GattaAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Massimo BolognesiAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Gianfranco FinucciAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Giorgio BattagliaAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Paolo AngeliAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua
  • , Renzo ZuinAffiliated withDepartments of Clinical Medicine and Surgery, University of Padua

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Abstract

Triglycyl-lysin-vasopressin is a long-acting vasopressin derivative which is under consideration for the treatment of acute variceal bleeding in cirrhosis. However, its splanchnic hemodynamic effects have not been investigated thoroughly. In 11 patients with alcoholic cirrhosis, systemic and splanchnic hemodynamics were evaluated before and 20–40 min after intravenous administration of 2 mg triglycyl-lysin-vasopressin. Following the drug administration, heart rate decreased by 10% and cardiac index by 22% on the average, respectively; mean arterial pressure increased by 14% and systemic vascular resistence index by 48%. Hepatic venous pressure gradient showed a marked and persistent fall, averaging 31%. Hepatic and splenic blood flow decreased by 31% and 56%, respectively. A significant correlation was found between the decrease in hepatic venous pressure gradient and in splenic blood flow. By contrast, the decrease in the hepatic venous pressure gradient was not significantly correlated to the decrease in hepatic blood flow or in cardiac index. We conclude that in patients with alcoholic cirrhosis, triglycyl-lysin-vasopressin decreases portal pressure as well as hepatic and splenic blood flows. The decrease in portal pressure was due to the decrease in splanchnic blood inflow and not to the decrease in cardiac index.

Key words

liver cirrhosis liver circulation vasopressin portal hypertension splenic circulation