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Measurement of Azygos Blood Flow

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Portal Hypertension

Abstract

Esophageal varices, because of their tendency to cause massive gastrointestinal hemorrhage, represent the more significant part of the portosystemic collateral circulation that develops in response to a chronic increase in portal pressure [1]. In recent years, much interest has been paid to the development of objective techniques allowing the quantification of hemodynamic abnormalities at the varices [2–4]. This has been mainly due to the recognition that, contrary to measurements of portal pressure, the endoscopic assessment of the size and appearance of the varices bear a good correlation with the likelihood of variceal hemorrhage [5–7]. This suggests that direct hemodynamic measurements at the varices may shed more light on the pathophysiology of bleeding and allow a better evaluation of new therapeutic approaches for portal hypertension [1,2,8,9].

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References

  1. Bosch J, Navasa M, García-Pagán JC, DeLacy AM, Rodés J (1989) Portal Hypertension. Med Clin North Am 73: 931–953

    PubMed  CAS  Google Scholar 

  2. Bosch J, Bordas JM, Rigau J, Viola C, Mastai R, Kravetz D, Navasa M, Rodés J (1986) Noninvasive measurement of the pressure of esophageal varices using an endoscopic gauge: Comparison with measurements by variceal puncture in patients undergoing endoscopic sclerotherapy. Hepatology 6: 667–672

    Article  PubMed  CAS  Google Scholar 

  3. Bosch J, Groszmann RJ (1984) Measurement of azygos venous blood flow by a continuous thermal dilution technique: An index of blood flow through gastroesophageal collaterals in cirrhosis. Hepatology 4: 424–429

    Article  PubMed  CAS  Google Scholar 

  4. Mosimann R (1982) Non-aggressive assessment of portal hypertension using endoscopie measurement of variceal pressure. Preliminary report. Am J Surg 143: 212–214

    Article  PubMed  CAS  Google Scholar 

  5. Beppu K, Inokuchi K, Koyanagi N, Nakayama S, Sakata H, Kitano S, Kobayashi M (1981) Prediction of variceal hemorrhage on esophageal endoscopy. Gastrointest Endosc 27: 213–218

    Article  PubMed  CAS  Google Scholar 

  6. Lebrec D, DeFleury P, Rueff B, Nahum H, Benhamou JP (1980) Portal hypertension, size of esophageal varices, and risk of gastrointestinal bleeding in alcoholic cirrhosis. Gastroenterology 79: 1139–1144

    PubMed  CAS  Google Scholar 

  7. The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices (1988) Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. N Engl J Med 319: 983–989

    Article  Google Scholar 

  8. Bosch J, Mastai R, Kravetz D, Bruix J, Rigau J, Rodés J (1985) Measurement of azygos venous blood flow in the evaluation of portal hypertension in patients with cirrhosis. Clinical and haemodynamic correlations in 100 patients. J Hepatol 1: 125–139

    Article  PubMed  CAS  Google Scholar 

  9. Bosch J, Mastai R, Kravetz D, Navasa M, Rodés J (1986) Hemodynamic evaluation of the patient with portal hypertension. Semin Liver Dis 6: 309–317

    Article  PubMed  CAS  Google Scholar 

  10. Polio J, Groszmann RJ (1986) Hemodynamic factors involved in the development and rupture of esophageal varices: A pathophysiologic approach to treatment. Semin Liver Dis 6: 318–331

    Article  PubMed  CAS  Google Scholar 

  11. Britton RC (1963) Influence of portal-systemic collateral patterns and distribution of varices on results of surgical treatment of bleeding esophageal varices. Surgery 53: 567–578

    PubMed  CAS  Google Scholar 

  12. Butler H (1951) The veins of the esophagus. Thorax 6: 267–296

    Article  Google Scholar 

  13. Hadengue A, Lee SS, Moreau R, Lebrec D (1987) Oxygen and bile acid content in the azygos blood. Clues to the azygos derivation in patients with portal hypertension. J Hepatol 5: 98–101

    Article  PubMed  CAS  Google Scholar 

  14. Calés P, Braillon A, Jirón MI, Lebrec D (1985) Superior portosystemic collateral circulation estimated by azygos blood flow in patients with cirrhosis. Lack of correlation with oesophageal varices and gastrointestinal bleeding. Effect of propranolol. J Hepatol 1: 37–46

    Article  Google Scholar 

  15. Biber B, Holm C, Winso O (1983) Portal blood flow in man during surgery, measured by a modification of the continuous thermodilution method. Scand J Gastroenterol 18: 233–239

    Article  PubMed  CAS  Google Scholar 

  16. Fronek A, Ganz W (1960) Measurement of flow in single blood vessels including cardiac output by local thermodilution. Circ Res 8: 175–182

    Article  Google Scholar 

  17. Ganz W, Swan HJC (1974) Measurement of blood flow by the thermodilution technique. In: Bloomfield DA (ed) Dye curves: The theory and practice of indicator dilution. University Park Press, Baltimore, pp 245–266

    Google Scholar 

  18. Linzell JL (1966) Measurement of venous flow by continuous thermodilution and its application to measurement of mammary blood flow in the goat. Circ Res 18: 745–754

    Article  PubMed  CAS  Google Scholar 

  19. Friedman PL, Brown EJ, Gunther S, Alexander RW, Barry WH, Mudge GH, Grossman W (1981) Coronary vasoconstrictor effect of indomethacin in patients with coronary artery disease. N Engl J Med 305: 1171–1175

    Article  PubMed  CAS  Google Scholar 

  20. Ganz W, Tamura K, Marcus HS (1971) Measurement of coronary sinus blood flow by continuous thermodilution in man. Circulation 44: 181–195

    Article  PubMed  CAS  Google Scholar 

  21. García-Tsao G, Groszmann RJ (1987) Portal hemodynamics during nitroglycerin administration in cirrhotic patients. Hepatology 7: 805–809

    Article  PubMed  Google Scholar 

  22. Haggmark S, Biber B, Sjodoin J (1982) The continuous thermodilution method for measuring high blood flows. Scand J Clin Lab Invest 42: 315–321

    Article  PubMed  CAS  Google Scholar 

  23. Mastai R, Grande L, Bosch J, Bruix J, Rigau J, Kravetz D, Navasa M, Pera C, Rodés J (1986) Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension. Hepatology 6: 1244–1247

    Article  PubMed  CAS  Google Scholar 

  24. Viola C, Bosch J, Mastai R, Terés J, Navasa M, Kravetz D, Grima N, Rodés J (1987) Prognostic value of measurements of portal pressure in patients with cirrhosis. J Hepatol 5 (Suppl. 1): S 71

    Google Scholar 

  25. Mastai R, Bosch J, Bordas JM, Bruix J, Kravetz D, Viola C, Rodés J (1985) Efecto de la esclerosis de varices esofágicas sobre el flujo sanguíneo de la vena ázigos en pacientes con hipertensión portal. Gastroenterol Hepatol 8: 174

    Google Scholar 

  26. Bosch J (1985) Effect of pharmacological agents on portal hypertension: A haemodynamic appraisal. Clin Gastroenterol 14: 169–184

    PubMed  CAS  Google Scholar 

  27. Bosch J, Mastai R, Kravetz D, Bruix J, Gaya J, Rigau J, Rodés J (1984) Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis. Hepatology 4: 1200–1205

    Article  PubMed  CAS  Google Scholar 

  28. García-Pagán JC, Navasa M, Bosch J, Bru C, Pizcueta P, Rodés J (1990) Enhancement of portal pressure reduction by the association of isosorbide-5-mononitrate to propranolol administration in patients with cirrhosis. Hepatology 11: 230–238

    Article  PubMed  Google Scholar 

  29. Hadengue A, Lee SS, Moreau R, Braillon A, Lebrec D (1987) Beneficial hemodynamic effects of ketanserin in patients with cirrhosis: Possible role of serotoninergic mechanisms in portal hypertension. Hepatology 7: 644–647

    Article  PubMed  CAS  Google Scholar 

  30. Mastai R, Bosch J, Navasa M, Kravetz D, Bruix J, Viola C, Rodés J (1987) Effects of alpha-adrenergic stimulation and beta-adrenergic blockade on azygos blood flow and splanchnic haemodynamics in patients with cirrhosis. J Hepatol 4: 71–79

    Article  PubMed  CAS  Google Scholar 

  31. Moreau R, Lee SS, Hadengue A, Braillon A, Lebrec D (1987) Hemodynamic effects of a clonidine-induced decrease in sympathetic tone in patients with cirrhosis. Hepatology 7: 149–154

    Article  PubMed  CAS  Google Scholar 

  32. Navasa M, Chesta J, Bosch J, Rodés J (1989) Reduction of portal pressure by isosorbide-5-mononitrate in patients with cirrhosis. Effects on splanchnic and systemic hemodynamics and liver function. Gastroenterology 96: 1110–1118

    PubMed  CAS  Google Scholar 

  33. Ruiz del Arbol L, García-Pagán JC, Feu F, Pizcueta P, Navasa M, Bosch J, Rodés J (1989) Effects of molsidomine, a long-acting venous dilator, on hepatic haemodynamics in patients with cirrhosis and portal hypertension. J Hepatol 9: S 86

    Google Scholar 

  34. Groszmann RJ, Kravetz D, Bosch J, Glickman M, Bruix J, Bredfeldt J, Conn HO, Rodés J (1982) Nitroglycerin improves the hemodynamic response to vasopressin in portal hypertension. Hepatology 2: 757–762

    Article  PubMed  CAS  Google Scholar 

  35. Bosch J, Kravetz D, Rodés J (1981) Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver: Comparison with vasopressin. Gastroenterology 80: 518–525

    PubMed  CAS  Google Scholar 

  36. Bosch J, Kravetz D, Mastai R, Bruix J, Rigau J, Rodés J (1983) Azygos venous blood flow in cirrhosis: Effects of balloon tamponade, vasopressin, somatostatin and propranolol. Hepatology 3: 855

    Google Scholar 

  37. Bosch J, Bordas JM, Mastai R, Kravetz D, Navasa M, Chesta J, Pizcueta P, García-Pagán JC, Rodés J (1988) Effects of vasopressin on the intravariceal pressure in patients with cirrhosis: Comparison with the effects on portal pressure. Hepatology 8: 861–865

    Article  PubMed  CAS  Google Scholar 

  38. Kroeger RJ, Groszmann RJ (1985) Increased portal venous resistance hinders portal pressure reduction during the administration of beta-adrenergic blocking agents in a portal hypertensive model. Hepatology 5: 97–101

    Article  PubMed  CAS  Google Scholar 

  39. Pizcueta P, De Lacy AM, Kravetz D, Bosch J, Rodés J (1989) Propranolol decreases portal pressure without changing porto collateral resistance in cirrhotic rats. Hepatology 10 953–957

    Article  PubMed  CAS  Google Scholar 

  40. Navasa M, García-Pagán JC, Chesta J, Bru C, Pizcueta P, Casamitjana R, Bosch J, Rodés J (1989) Cambios posprandiales de la presión portal en la cirrosis hepática. Relatión con los niveles de glucagón plasmático. Gastroenterol Hepatol 12: 231–232

    Google Scholar 

  41. Lee SS, Moreau R, Hadengue A, Cerini R, Koshy A, Lebrec D (1988) Glucagon selectively increases splanchnic blood flow in patients with well-compensated cirrhosis. Hepatology 8: 1501–1505

    Article  PubMed  CAS  Google Scholar 

  42. Silva G, Navasa M, Bosch J, Chesta J, Pizcueta P, Casamitjana R, Rivera F, Rodés J (1990) Hemodynamic effects of glucagön in portal hypertension. Hepatology 11: 668–673

    Article  PubMed  CAS  Google Scholar 

  43. Valla D, Gaudin C, Geoffroy P, Braillon A, Lee SS, Lebrec D (1987) Reversal of adrenaline-induced increase in azygos blood flow in patients with cirrhosis receiving propranolol. J Hepatol 4: 86–92

    Article  PubMed  CAS  Google Scholar 

  44. Feu F, García-Pagán JC, Ruiz del Arbol L, De Lacy AM, Navasa M, Bosch J, Rodés J (1989) Favorable effects of propranolol in patients with malfunctioning porto-caval or distal splenorenal shunts. J Hepatol 9 (Suppl 1): S 149

    Google Scholar 

  45. Burns P, Taylor K, Blei AT (1987) Doppler flowmetry and portal hypertension. Gastroenterology 92: 824–826

    PubMed  CAS  Google Scholar 

  46. Navasa M, Bosch J, Chesta J, Bru C, Pizcueta P, García-Pagán JC, Betz C, Casamitjana R, Rodés J (1988) Hemodynamic effects of subcutaneous administration of SMS 201-995, a long acting somatostatin analog, in patients with cirrhosis and portal hypertension. J Hepatol 7 (Suppl 1): S 64

    Google Scholar 

  47. Koshy A, Hadengue A, Lee SS, Jiron MI, Lebrec D (1987) Possible deleterious hemodynamic effect of nifedipine on portal hypertension in patients with cirrhosis. Clin Pharmacol Ther 42: 295–298

    Article  PubMed  CAS  Google Scholar 

  48. Hadengue A, Moreau R, Cerini R, Koshy A, Lee SS, Lebrec D (1989) Combination of ketanserin and verapamil or propranolol in patients with alcoholic cirrhosis: Search for an additive effect. Hepatology 9: 83–87

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Hepatic Haemodynamics Laboratory, Liver Unit, Hospital Clínic i Provincial, University of Barcelona, 08034, Barcelona, Spain

    Joan-Carles García-Pagán

Authors
  1. Jaime Bosch
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  2. Faust Feu
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  3. Joan-Carles García-Pagán
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Editor information

Editors and Affiliations

  1. Department of Medicine, Chiba University Hospital, Inohana 1-8-1, Chiba, 280, Japan

    Kunio Okuda M.D., Ph.D. (Professor) (Professor)

  2. Department of Hepatology, Hopital Beaujon, 92118, Clichy, France

    Jean-Pierre Benhamou M.D. (Professor) (Professor)

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© 1991 Springer Japan

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Bosch, J., Feu, F., García-Pagán, JC. (1991). Measurement of Azygos Blood Flow. In: Okuda, K., Benhamou, JP. (eds) Portal Hypertension. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68361-2_11

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  • DOI: https://doi.org/10.1007/978-4-431-68361-2_11

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68363-6

  • Online ISBN: 978-4-431-68361-2

  • eBook Packages: Springer Book Archive

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