Effect of continuous infusion and bolus injections of somatostatin (SMT) on azygos blood flow and hepatic and systemic hemodynamics in patients with portal hypertension. Comparison with vasopressin

Background: The farnesoid X receptor (FXR) influences hepatic metabolism, inflammation and liver fibrosis as key components of non-alcoholic steatohepatitis (NASH). We studied the effects of the non-steroidal FXR agonist cilofexor (formerly GS-9674) on portal pressure and fibrosis in experimental NASH. Methods: NASH was induced in Wistar rats using a choline-deficient high-fat diet plus intraperitoneal sodium nitrite injections. First, a dose-finding study was performed with 10 mg/kg and 30 mg/kg of cilofexor, focusing on histological readouts. Liver fibrosis was assessed by Picro-Sirius-Red, desmin staining and hepatic hydroxyproline content. Gene expression was determined by RT-PCR. In a subsequent hemodynamic study, rats received 30 mg/kg cilofexor with or without propranolol (25 mg/kg). Portal pressure, systemic hemodynamics and splanchnic blood flow were measured. Results: Cilofexor dose-dependently induced FXR target genes shp, cyp7a1 and fgf15 in hepatic and ileal tissues, paralleled by a dose-dependent reduction in liver fibrosis area (Picro-Sirius-Red) of −41% (10 mg/kg) and −69% (30 mg/kg), respectively. The 30 mg/kg cilofexor dose significantly reduced hepatic hydroxyproline content (−41%), expression of col1a1 (−37%) and pdgfr-β (−36%), as well as desmin area (−42%) in NASH rats. Importantly, cilofexor decreased portal pressure (11.9 ± 2.1 vs. 8.9 ± 2.2 mmHg; p = 0.020) without affecting splanchnic blood-flow or systemic hemodynamics. The addition of propranolol to cilofexor additionally reduced splanchnic inflow (−28%) but also mean arterial pressure (−25%) and heart rate (−37%). Conclusion: The non-steroidal FXR agonist cilofexor decreased portal hypertension and reduced liver fibrosis in NASH rats. While cilofexor seems to primarily decrease sinusoidal resistance in cirrhotic portal hypertension, the combination with propranolol additionally reduced mesenteric hyperperfusion.

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Patterns of Cerebral Blood Flow and Systemic Hemodynamics During Arithmetic Processing

Journal of Psychophysiology ◽

10.1027/0269-8803.22.2.81 ◽

2008 ◽

Vol 22 (2) ◽

pp. 81-90 ◽

Cited By ~ 21

Author(s):

Natalie Werner ◽

Neval Kapan ◽

Gustavo A. Reyes del Paso

Keyword(s):

Blood Pressure ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Time Course ◽

Doppler Sonography ◽

Transcranial Doppler Sonography ◽

Systemic Hemodynamics ◽

Heart Period ◽

Blood Flow Velocities ◽

Flow Velocities

The present study explored modulations in cerebral blood flow and systemic hemodynamics during the execution of a mental calculation task in 41 healthy subjects. Time course and lateralization of blood flow velocities in the medial cerebral arteries of both hemispheres were assessed using functional transcranial Doppler sonography. Indices of systemic hemodynamics were obtained using continuous blood pressure recordings. Doppler sonography revealed a biphasic left dominant rise in cerebral blood flow velocities during task execution. Systemic blood pressure increased, whereas heart period, heart period variability, and baroreflex sensitivity declined. Blood pressure and heart period proved predictive of the magnitude of the cerebral blood flow response, particularly of its initial component. Various physiological mechanisms may be assumed to be involved in cardiovascular adjustment to cognitive demands. While specific contributions of the sympathetic and parasympathetic systems may account for the observed pattern of systemic hemodynamics, flow metabolism coupling, fast neurogenic vasodilation, and cerebral autoregulation may be involved in mediating cerebral blood flow modulations. Furthermore, during conditions of high cardiovascular reactivity, systemic hemodynamic changes exert a marked influence on cerebral blood perfusion.

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Four-Dimensional Flow MRI of Abdominal Veins: A Systematic Review

Diagnostics ◽

10.3390/diagnostics11050767 ◽

2021 ◽

Vol 11 (5) ◽

pp. 767

Author(s):

Simon O. Haarbye ◽

Michael B. Nielsen ◽

Adam E. Hansen ◽

Carsten A. Lauridsen

Keyword(s):

Systematic Review ◽

Blood Flow ◽

Portal Hypertension ◽

Healthy Subjects ◽

Visual Quality ◽

Sampling Strategies ◽

4D Flow Mri ◽

4D Flow ◽

Dimensional Flow ◽

Flow Mri

The aim of this systematic review is to provide an overview of the use of Four-Dimensional Magnetic Resonance Imaging of vector blood flow (4D Flow MRI) in the abdominal veins. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in MEDLINE, Cochrane Library, EMBASE, and Web of Science. Quality assessment of the included studies was performed using the QUADAS-2 tool. The initial search yielded 781 studies and 21 studies were included. All studies successfully applied 4D Flow MRI in abdominal veins. Four-Dimensional Flow MRI was capable of discerning between healthy subjects and patients with cirrhosis and/or portal hypertension. The visual quality and inter-observer agreement of 4D Flow MRI were rated as excellent and good to excellent, respectively, and the studies utilized several different MRI data sampling strategies. By applying spiral sampling with compressed sensing to 4D Flow MRI, the blood flow of several abdominal veins could be imaged simultaneously in 18–25 s, without a significant loss of visual quality. Four-Dimensional Flow MRI might be a useful alternative to Doppler sonography for the diagnosis of cirrhosis and portal hypertension. Further clinical studies need to establish consensus regarding MRI sampling strategies in patients and healthy subjects.

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Evaluation of perfusion changes using a 2D Parametric Parenchymal Blood Flow technique with automated vessel suppression following partial spleen embolization in patients with hypersplenism and portal hypertension

Medicine ◽

10.1097/md.0000000000024783 ◽

2021 ◽

Vol 100 (7) ◽

pp. e24783

Author(s):

Timo C. Meine ◽

Sabine K. Maschke ◽

Martha M. Kirstein ◽

Elmar Jaeckel ◽

Becker S. Lena ◽

...

Keyword(s):

Blood Flow ◽

Portal Hypertension

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Correction of extrahepatic portal hypertension in pediatric patient after liver transplantation

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2017-1-47-51 ◽

2017 ◽

Vol 19 (1) ◽

pp. 47-51

Author(s):

A. R. Monakhov ◽

B. L. Mironkov ◽

T. A. Dzhanbekov ◽

K. O. Semash ◽

Kh. M. Khizroev ◽

...

Keyword(s):

Liver Transplantation ◽

Blood Flow ◽

Portal Hypertension ◽

Portal Vein ◽

Pediatric Patient ◽

Portal Blood Flow ◽

Portal Blood ◽

Positive Trend ◽

Portal Vein Stenosis ◽

Vein Stenosis

Introduction. Liver transplantation is a multi-component and complex type of operative treatment. Patients undergoing such a treatment sometimes are getting various complications. One of these complications is a portal hypertension associated with portal vein stenosis.Materials and methods. In 6 years after the left lateral section transplantation from living donor in a pediatric patient the signs of portal hypertension were observed. Stenosis of the portal vein was revealed. Due to this fact percutaneous transhepatic correction of portal vein stenosis was performed.Results. As a result of the correction of portal blood flow in the patient a positive trend was noted. According to the laboratory and instrumental methods of examination the graft had a normal function, portal blood flow was adequate. In order to control the stent patency Doppler ultrasound and MSCT of the abdominal cavity with intravenous bolus contrasting were performed. Due to these examinations the stent function was good, the rate of blood flow in the portal vein due to Doppler data has reached 80 cm/sec, and a decrease of the spleen size was noted.Conclusion. Diagnosis and timely detection of portal vein stenosis in patients after liver transplantation are very important for the preservation of graft function and for the prevention of portal hypertension. In order to do that, ultrasound Doppler fluorimetry examination needs to be performed to each patient after liver transplantation. In cases of violation of the blood flow in the portal vein CT angiography performance is needed. Percutaneous transhepatic stenting of portal vein is a minimally invasive and highly effective method of correction of portal hypertension. Antiplatelet therapy and platelet aggregation control are the prerequisites for successful stent function.

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Noninvasive diagnosis of portal hypertension and esophageal varices through the identification of liver blood flow markers

Hepatology ◽

10.1002/hep.26897 ◽

2014 ◽

Vol 60 (2) ◽

pp. 762-762 ◽

Cited By ~ 1

Author(s):

Andrea Lisotti ◽

Francesco Azzaroli ◽

Marco Montagnani ◽

Giuseppe Mazzella

Keyword(s):

Blood Flow ◽

Portal Hypertension ◽

Esophageal Varices ◽

Liver Blood Flow ◽

Noninvasive Diagnosis

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Systemic and Splanchnic Lipopolysaccharide and Endothelin-1 Plasma Levels in Liver Cirrhosis before and after Transjugular Intrahepatic Portosystemic Shunt

Gastroenterology Research and Practice ◽

10.1155/2016/8341030 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Jiaxiang Meng ◽

Qing Wang ◽

Kai Liu ◽

Shuofei Yang ◽

Xinxin Fan ◽

...

Keyword(s):

Blood Flow ◽

Liver Cirrhosis ◽

Portal Hypertension ◽

Portal Vein ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Bacterial Translocation ◽

Portosystemic Shunt ◽

Before And After ◽

Intrahepatic Portosystemic Shunt ◽

Cirrhotic Patients

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.

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