Effects of alpha-adrenergic stimulation and beta-adrenergic blockade on azygos blood flow and splanchnic haemodynamics in patients with cirrhosis.

Abstract

The effects of beta-blockade with propranolol and of alpha-adrenergic stimulation with methoxamine, a powerful alpha-agonist, on azygos blood flow and on systemic and hepatic haemodynamics were investigated in 26 cirrhotic patients with portal hypertension. Beta-adrenergic blockade with propranolol (n = 12), evidenced by a significant reduction of heart rate (-17 +/- 1%, P less than 0.001) and cardiac index (-17 +/- 2%, P less than 0.001), caused a mild but significant decrease of hepatic venous pressure gradient (-10 +/- 2%, P less than 0.05) and a marked fall of azygos venous blood flow (-31 +/- 5%, P less than 0.05). Alpha-adrenergic stimulation with methoxamine (n = 14), manifested by a significant increase of mean arterial pressure (19 +/- 2%, P less than 0.001), mimicked the effects of propranolol on hepatic venous pressure gradient (-10 +/- 4%, P less than 0.05) and cardiac index (-11 +/- 2%, P less than 0.001). However, azygos blood flow was not significantly reduced by methoxamine (0.7 +/- 0.1 vs 0.6 +/- 0.1 l/min). On the contrary, hepatic blood flow was significantly reduced by methoxamine (-19 +/- 4%, P less than 0.01) but not by propranolol (-7 +/- 7%, ns). Similarly, in 8 patients who received methoxamine after being beta-blocked by propranolol, azygos blood flow, that was markedly reduced by beta-blockade, did not experience a further reduction but increased slightly by alpha-adrenergic stimulation, while hepatic blood flow, that was not reduced by propranolol, decreased significantly during the subsequent methoxamine infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: R Mastai, J Bosch, M Navasa, D Kravetz, J Bruix, C Viola, J Rodés
• Journal: Journal of hepatology (J Hepatol) Vol. 4 Issue 1 Pg. 71-9 (Feb 1987) ISSN: 0168-8278 [Print] Netherlands
• PMID: 3033061 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Receptors, Adrenergic, alpha
• Receptors, Adrenergic, beta
• Propranolol
• Methoxamine

Topics

• Azygos Vein (physiopathology)
• Female
• Hemodynamics (drug effects)
• Humans
• Hypertension, Portal (complications, physiopathology)
• Liver Circulation (drug effects)
• Liver Cirrhosis (complications, physiopathology)
• Male
• Methoxamine (pharmacology)
• Middle Aged
• Propranolol (pharmacology)
• Receptors, Adrenergic, alpha (drug effects, physiology)
• Receptors, Adrenergic, beta (drug effects, physiology)
• Splanchnic Circulation (drug effects)