Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension

Authors

  • Ricardo Mastai,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Luis Grande,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Jaime Bosch M.D.,

    Corresponding author
    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
    • Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic i Provincial, Villarroel, 170, 08036 Barcelona, Spain
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  • Jordi Bruix,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Joaquim Rigau,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • David Kravetz,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Miguel Navasa,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Cristobal Pera,

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • Joan Rodés

    1. Hepatic Hemodynamic Laboratory, Liver Unit and Department of Surgery, Hospital Clinic i Provincial, University of Barcelona, School of Medicine, 08036 Barcelona, Spain
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  • This study was presented at the 19th Meeting of the European Association for the Study of the Liver, Berne, Switzerland, September, 1984.

Abstract

The effects of pharmacological manipulation of the lower esophageal sphincter pressure on the esophageal circulation in patients with cirrhosis and portal hypertension were investigated in 33 patients by measuring the azygos venous blood flow, which is an index of blood flow through esophageal varices and periesophageal collaterals draining into the azygos venous system. Measurements were performed in baseline conditions and after the blind administration of metoclopramide (20 mg i.v.) (12 patients), domperidone (10 mg i.v.) (12 patients) and placebo (9 patients).

Both metoclopramide and domperidone caused a significant reduction of azygos blood flow, that decreased by 11.5% (p < 0.01) and 15.6% (p < 0.02) respectively, while no change was observed in patients receiving placebo (+1.4%, not statistically significant). Reduction of azygos blood flow represents a selective effect of metoclopramide and domperidone on the esophageal circulation, since portal pressure, hepatic blood flow, cardiac output, heart rate and arterial blood pressure were unchanged by the administration of metoclopramide, domperidone or placebo.

These results indicate that the administration of drugs that increase the lower esophageal sphincter pressure may reduce the inflow of blood into the esophageal varices in cirrhotic patients with portal hypertension.

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