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Sildenafil does not influence hepatic venous pressure gradient in patients with cirrhosis.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2008 Oct 28; Vol. 14 (40), pp. 6208-12. - Publication Year :
- 2008
-
Abstract
- Aim: To investigate if sildenafil increases splanchnic blood flow and changes the hepatic venous pressure gradient (HVPG) in patients with cirrhosis. Phosphodiesterase type-5 inhibitors are valuable in the treatment of erectile dysfunction and pulmonary hypertension in patients with end-stage liver disease. However, the effect of phosphodiesterase type-5 inhibitors on splanchnic blood flow and portal hypertension remains essentially unknown.<br />Methods: Ten patients with biopsy proven cirrhosis (five females/five males, mean age 54 +/- 8 years) and an HVPG above 12 mmHg were studied after informed consent. Measurement of splanchnic blood flow and the HVPG during liver vein catheterization were done before and 80 min after oral administration of 50 mg sildenafil. Blood flow was estimated by use of indocyanine green clearance technique and Fick's principle, with correction for non-steady state.<br />Results: The plasma concentration of sildenafil was 222 +/- 136 ng/mL 80 min after administration. Mean arterial blood pressure decreased from 77 +/- 7 mmHg to 66 +/- 12 mmHg, P = 0.003, while the splanchnic blood flow and oxygen consumption remained unchanged at 1.14 +/- 0.71 L/min and 2.3 +/- 0.6 mmol/min, respectively. Also the HVPG remained unchanged (18 +/- 2 mmHg vs 16 +/- 2 mmHg) with individual changes ranging from -8 mmHg to +2 mmHg. In seven patients, HVPG decreased and in three it increased.<br />Conclusion: In spite of arterial blood pressure decreases 80 min after administration of the phosphodiesterase type-5 inhibitor sildenafil, the present study could not demonstrate any clinical relevant influence on splanichnic blood flow, oxygen consumption or the HVPG.
- Subjects :
- Administration, Oral
Adult
Female
Humans
Hypertension, Portal etiology
Hypertension, Portal physiopathology
Liver Cirrhosis complications
Liver Cirrhosis physiopathology
Male
Middle Aged
Oxygen Consumption drug effects
Phosphodiesterase Inhibitors administration & dosage
Phosphodiesterase Inhibitors blood
Piperazines administration & dosage
Piperazines blood
Purines administration & dosage
Purines blood
Purines therapeutic use
Sildenafil Citrate
Sulfones administration & dosage
Sulfones blood
Time Factors
Treatment Outcome
Vasodilator Agents administration & dosage
Vasodilator Agents blood
Hypertension, Portal drug therapy
Liver Cirrhosis drug therapy
Phosphodiesterase 5 Inhibitors
Phosphodiesterase Inhibitors therapeutic use
Piperazines therapeutic use
Splanchnic Circulation drug effects
Sulfones therapeutic use
Vasodilator Agents therapeutic use
Venous Pressure drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1007-9327
- Volume :
- 14
- Issue :
- 40
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 18985812
- Full Text :
- https://doi.org/10.3748/wjg.14.6208