Hemodynamic Characteristics of Portopulmonary Hypertension : An Evaluation of Five Patients

• Published in: Japanese Journal of Portal Hypertension Vol. 5; no. 1; pp. 67 - 72
• Main Authors: Sekiyama, Tatsuya, Terada, Hideto, Katsuta, Yasumi, Zhang, Xuejun, Satomura, Katsuaki, Aramaki, Takumi, Nagano, Tomoo, Komeichi, Hirokazu, Shimizu, Shuji, Ohsuga, Masaru
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Portal Hypertension 1999
• Subjects: circulating plasma volume; portal hypertension; portopulmonary hypertension; pulmonary hypertension; systemic hemodynamics
• ISSN: 1344-8447; 2186-6376
• DOI: 10.11423/jsph1999.5.1_67

We retrospectively studied the hemodynamic characteristics of liver cirrhosis complicated by idiopathic pulmonary hypertension (PH), and compared the results with those of chronic hepatitis and liver cirrhosis without PH. Etiology of liver cirrhosis was excess alcohol intake in 2, hemochromatosis in 1, autoimmune hepatitis in 1 and hepatitis C in 1 case. The age of diagnosis ranged between 42 and 64 years. Prevalence of PH ascertained by right cardiac catheterization was 2% (5 cases) among 250 patients with liver cirrhosis. In these 5 patients, mean pressure of the pulmonary artery was 42.4±12.1 mmHg (mean±SD). Mean vascular resistance of the pulmonary artery was 832±400 dynes·sec·cm-5/m2 and the cardiac index (CI) was 3.13±0.66 l/ min/m2 CI in 41 patients without PH was 4.26±0.90 l/min/m2, and significantly higher than that of the patients with PH (p<0.01). Mean systemic vascular resistance was significantly higher, and circulating plasma volume was significantly smaller in patients with PH than patients without PH (2438±743 vs 757±228 dynes·sec·cm-5/m2, p<0.01 and 1.71±0.36 vs 2.07±0.29 l/min/m2, p<0.05, respectively). These results suggest that hyperdynamic systemic circulation commonly seen in patients with cirrhosis is normalized by the complication of PH.