Title of article :
Cardiovascular and renal function in normotensive and hypertensive patients with compensated cirrhosis: effects of posture
Author/Authors :
Paolo Gentilini، نويسنده , , Roberto Giulio Romanelli، نويسنده , , Giacomo Laffi، نويسنده , , Giuseppe Barletta، نويسنده , , Riccarda Del Bene، نويسنده , , Gianni Messeri، نويسنده , , Giorgio La Villa، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1999
Pages :
7
From page :
632
To page :
638
Abstract :
Background/Aims: The aim of this study was to evaluate cardiovascular and renal function in patients with compensated cirrhosis and essential hypertension in the supine position and in response to standing up. Methods: Twenty-four patients with compensated cirrhosis (12 with elevated arterial pressure) and 20 healthy volunteers underwent echocardiographic evaluation of left ventricular end-diastolic and stroke volumes, ejection fraction, cardiac index, arterial pressure, peripheral resistance, creatinine clearance and sodium excretion in both the supine and the standing position. Results: When supine, only normotensive patients had a hyperdynamic circulation, with increased left ventricular end-diastolic and stroke volumes, cardiac index, and ejection fraction, and reduced peripheral resistance. Creatinine clearance and sodium excretion were comparable in patients and controls. Standing induced a decrease in end-diastolic volume in all subjects. Healthy volunteers maintained cardiovascular homeostasis by increasing ejection fraction and heart rate, while both normotensive and hypertensive cirrhotic patients experienced a fall in stroke volume and cardiac index, despite a marked activation of the renin-aldosterone and sympathetic nervous system. Creatinine clearance decreased only in normotensive patients, who experienced the greatest reduction in sodium excretion. Conclusions: Compensated cirrhotic patients with arterial hypertension had no evidence of hyperdynamic circulation. Like their normotensive counterparts, hypertensive patients had an impaired cardiovascular response to the postural challenge, but a lesser degree of renal dysfunction during standing
Keywords :
Cirrhosis , heart , Systemichemodynamics. , hypertension
Journal title :
Journal of Hepatology
Serial Year :
1999
Journal title :
Journal of Hepatology
Record number :
584482
Link To Document :
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