Skip to main content

Table 1 Hemodynamic responses to drugs in cirrhotic patients

From: Quantitative modeling of the physiology of ascites in portal hypertension

Drug

Δt

CO

HBF

PRA

Wedge

Free

PHVPG

Resistance

Δ(PL - PA)

Comments

 

Hours

Pre

Post

Pre

Post

Pre

Post

Pre

Post

Pre

Post

Pre

Post

Pre

Post

Eq. 16

Eq. 17

 

Spironolactone

                  

[51]

1440

8.6

7.3

1.33

1.24

3.5

1.8

23.9

20.8

6.4

5.5

17.6

15.3

13.2

12.3

2.0

1.15

No ascites

[52]

168

6.75

NR

NR

 

NR

 

26.3

23.5

9.8

10.6

16.5

12.9

NR

NR

1.0

1.8

70% ascites

[53]

672

6.48

5.76

1.00

1.00

NR

 

18.7

15.7

2.2

2.8

16.5

12.9

16.5

12.9

1.2

1.8

No ascites

[54]

1344

5.5

4.9

1.0

0.94

NR

 

22.4

20.1

4.9

4.4

17.5

15.7

17.5

16.7

1.4

0.9

No ascites, unrestricted Na+

Furosemide

                  

[53]

672

8.4

6.78

1.29

1.08

NR

 

17.6

16.7

3.9

3.1

13.7

13.6

10.6

12.5

0.85

0.05

No ascites

[55]

1

6.6

5.5

1.49

0.82

5

3

31.1

27.7

9.0

8.2

22.1

19.5

14.8

23.8

2.1

1.3

Acute affect, 60% ascites

Propranolol

                  

[56]

1

7.6

5.9

1.06

0.862

3.7

5.5

23.8

22.9

5.7

7.0

18.1

15.9

17.1

18.4

-0.2

1.1

Varices and/or ascites

[57]

240

8.13

5.36

1.5

1.8

NR

 

29.7

26.9

8.6

10.1

21.1

16.8

14.1

9.3

0.65

2.15

45% ascites

[58]

672

6.05

5.0

0.93

0.826

1.9

1.1

19.3

14.5

3.6

3.2

15.1

11.4

16.2

13.8

2.6

1.85

No ascites

[59]

1/4

6.33

5.01

NR

 

NR

 

27.9

25.7

7.0

8.0

20.9

17.7

NR

NR

0.6

1.6

Mild--6% ascites

[59]

1/4

7.17

5.76

NR

 

NR

 

31.3

29.2

7.1

8.4

24.2

20.8

NR

NR

0.4

1.7

Moderate--72% ascites

[59]

1/4

9.03

5.92

NR

 

NR

 

32.1

29.6

8.8

9.5

23.4

20.1

NR

NR

0.9

1.65

Severe--100% ascites

[60]

1848

7.6

5.8

1.25

1.01

5.8

6.4

28.8

25.9

8.5

8.3

20.3

17.6

16.2

17.4

1.55

1.35

Varices, PHVPG> 12

[61]

2160

NR

 

NR

 

NR

 

27.5

26.0

10.0

13.9

17.3

12.1

NR

NR

-1.2

2.6

100% variceal bleed

[62]

336

NR

 

NR

 

8.8

12.2

34.5

32.7

15.8

17.1

18.7

15.45

NR

NR

0.25

1.63

75% ascites

Timolol

                  

[63]

1

NR

 

NR

 

NR

 

24.9

23.6

8.4

10.0

16.5

14.4

NR

NR

-0.15

1.05

100% varices

Carvedilol

                  

[60]

1848

7.5

6.4

1.39

1.28

4.6

5.5

26.4

23.5

7.3

8.2

19.0

15.2

13.7

11.9

1.0

1.9

Varices, PHVPG> 12

Clonidine

                  

[64]

168

6.41

5.40

1.05

1.33

5.2

3.4

30.4

27.4

10.2

9.7

20.1

17.6

19.1

13.2

1.75

1.25

100% Ascites

[65]

3/4

6.40

5.36

0.96

1.22

NR

 

31.3

28

11.0

11.4

20.3

16.6

21.1

13.6

1.45

1.85

100% Ascites

[66]

448

7.8

6.7

1.2

1.1

2.6

4.2

23.9

24.6

5.1

8.7

18.8

15.9

15.7

14.4

-2.15

1.45

40% ascites

Nitroglycerin

                  

[67]

≈1/10

NR

 

NR

 

NR

 

22.5

18.9

4.6

3.6

17.9

15.1

NR

NR

2.3

1/4

Sublingual

[68]

1

NR

 

0.93

0.919

NR

 

26.0

22.1

8.4

8.6

17.6

13.6

NR

NR

1.85

2

Transdermal

[69]

1/3

7.42

6.75

1.34

1.1

6.1

4.0

29.2

29.3

8.3

8.2

20.9

21.1

15.7

14.4

0

00.1

Low dose IV, 53% ascites

Vasopressin

                  

[70]

1/2

NR

 

NR

 

NR

 

28.6

24.0

5.7

6.3

22.9

17.7

NR

NR

2.0

2.6

Bleeding varices, 40% ascites

[71]

1/2

7.6

6.5

1.89

1.06

5.0

7.5

26.6

23.6

7.6

9.1

19.0

14.6

10.1

13.8

0.75

2.2

30 min IV inf

[72]

1/2

7.14

5.77

1.35

0.91

NR

 

17.8

12.7

6.7

7.3

11.1

5.4

8.22

5.93

2.25

2.85

40% ascites, IV inf

Terlipressin

                  

[73]

1

NR

NR

NR

NR

5.2

9

25.4

25.0

6.0

8.1

19.4

16.8

NR

NR

-0.85

1.3

Variceal gradient reduction

Captopril

                  

[74]

504

NR

 

NR

 

NR

 

22.9

20.7

15.0

12.1

7.58

9.32

NR

NR

2.55

-0.5

100% ascites

[61]

2160

NR

 

NR

 

NR

 

24.8

21.1

9.3

7.1

15.6

13.0

NR

NR

2.95

1.3

100% variceal bleed

Enalaprilat

                  

[75]

1/2

6.7

6.9

NR

 

NR

 

32.1

25.6

11.2

10.8

21.0

16.1

NR

NR

3.45

2.45

IV infusion

Losartan

                  

[62]

336

NR

 

NR

 

8.4

8.55

32.4

28.31

13.21

14.26

19.21

14.15

NR

NR

1.53

2.53

63% ascites

[76]

 

5.8

5.7

NR

 

NR

 

20.3

17.3

4.9

3.7

15.4

13.6

NR

NR

2.1

0.9

Pre-ascitic, 4 week

Saralasin

                  

[77]

≈1/2

6.5

5.97

1.42

1.35

4.8

4.3

28

24.0

10.8

10.2

17.2

13.78

12.1

10.2

2.31

1.71

100% ascites, IV inf

Somatostatin

                  

[72]

1/2

6.59

6.38

3.7

1.1

0.89

4.1

19.5

16.2

7.2

7.6

12.3

8.6

3.32

7.82

1.45

1.85

40% ascites, IV inf

Fenoldopam

                  

[78]

1

8.9

10.5

1.5

1.6

6.1

4.4

24.6

28.0

9.2

8.7

15.4

19.3

10.23

12.1

-1.45

-1.95

MAP: 84.6-61.8 decrease

  1. Δt = time interval pre--post (hours), CO = cardiac output (liters/min), HBF = hepatic blood flow (liters/min), PRA = right atrial pressure (mm Hg),
  2. Wedge = portal wedge pressure (mm Hg), Free = free portal pressure (mm Hg), PHVPG = Wedge - Free, Resistance = hepatic flow resistance = Gradient/HBF (mm Hg/liter),
  3. Δ(PL - PA) = change in pressure difference across the liver capsule--(pre - post), MAP = mean arterial pressure
Back to article page

BMC Gastroenterology

ISSN: 1471-230X

Contact us