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Sildenafil does not influence hepatic venous pressure gradient in patients with cirrhosis

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@article{a3f73555dd1b421b83a9025eb9a4acb5,
title = "Sildenafil does not influence hepatic venous pressure gradient in patients with cirrhosis",
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.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.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.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.",
keywords = "Administration, Oral, Adult, Female, Humans, Hypertension, Portal, Liver Cirrhosis, Male, Middle Aged, Oxygen Consumption, Phosphodiesterase 5 Inhibitors, Phosphodiesterase Inhibitors, Piperazines, Purines, Sildenafil Citrate, Splanchnic Circulation, Sulfones, Time Factors, Treatment Outcome, Vasodilator Agents, Venous Pressure, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't",
author = "Jens-Otto Clemmesen and Annamaria Giraldi and Peter Ott and Kim Dalhoff and Bent-Adel Hansen and Fin-Stolze Larsen",
year = "2008",
month = oct,
day = "28",
language = "English",
volume = "14",
pages = "6208--12",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "W J G Press",
number = "40",

}

RIS

TY - JOUR

T1 - Sildenafil does not influence hepatic venous pressure gradient in patients with cirrhosis

AU - Clemmesen, Jens-Otto

AU - Giraldi, Annamaria

AU - Ott, Peter

AU - Dalhoff, Kim

AU - Hansen, Bent-Adel

AU - Larsen, Fin-Stolze

PY - 2008/10/28

Y1 - 2008/10/28

N2 - 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.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.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.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.

AB - 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.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.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.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.

KW - Administration, Oral

KW - Adult

KW - Female

KW - Humans

KW - Hypertension, Portal

KW - Liver Cirrhosis

KW - Male

KW - Middle Aged

KW - Oxygen Consumption

KW - Phosphodiesterase 5 Inhibitors

KW - Phosphodiesterase Inhibitors

KW - Piperazines

KW - Purines

KW - Sildenafil Citrate

KW - Splanchnic Circulation

KW - Sulfones

KW - Time Factors

KW - Treatment Outcome

KW - Vasodilator Agents

KW - Venous Pressure

KW - Clinical Trial

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Journal article

C2 - 18985812

VL - 14

SP - 6208

EP - 6212

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 40

ER -

ID: 49582132