Effects of terlipressin on systemic, hepatic and renal hemodynamics in patients with cirrhosis

概要

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The effect of terlipressin on systemic, hepatic, and renal hemodynamics was studied by means of catheterization of hepatic vein and pulmonary artery, and duplex Doppler ultrasonography of portal and splenic vein performed before and after intravenous administration of 1 mg terlipressin in 10 patients with liver cirrhosis. Following terlipressin administration, mean arterial pressure and systemic vascular resistance increased significantly, and heart rate and cardiac output decreased significantly. Hepatic venous pressure gradient and portal venous blood flow decreased significantly by 19.4% (18.6 mm Hg to 15.0 mm Hg) and 32.5% (714 ml/min to 482 ml/min), respectively. Renal arterial resistive index decreased significantly (0.74 to 0.69). There were no severe adverse events. These results suggest that terlipressin decreases portal pressure through the reduction of portal blood flow, attenuates the hyperdynamic circulation, and decreases renal arterial resistance in liver cirrhosis. It is expected that terlipressin have beneficial effects on hemodynamics in cirrhotic patients with hepatorenal syndrome.
The Japan Society for Portal Hypertensionの論文