Systemic and splanchnic hemodynamic changes in patients with hepatic schistosomiasis

Authors

  • Cécile Denié,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Florence Vachiery,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Annie Elman,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Thierry Soupison,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Adrian Gadano,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Richard Moreau,

    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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  • Didier Lebrec

    Corresponding author
    1. Laboratoire d'Hémodynamique Splanchnique, Unité de Recherche de Physiopathologie Hépatique (INSERM U-24) and Service d'Hépatologie, Hǒpital Beaujon, Clichy, France
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INSERM U-24, Hǒpital Beaujon, F 92118 Clichy, France

Abstract

Abstract: Although hepatic schistosomiasis is a common cause of portal hypertension, only a few hemodynamic studies, in humans, have been published on this subject. The aim of this study was to determine the systemic and splanchnic hemodynamic changes in hepatic schistosomiasis and to evaluate the influence of liver fibrosis on these changes. A retrospective analysis of a series of 13 patients with hepatic schistosomiasis who had undergone hemodynamic studies was performed. Portal or perisinusoidal fibrosis was present at liver biopsy in 8 patients. The control group included 22 patients with chronic hepatitis and normal hepatic venous pressure gradients. Patients with schistosomiasis exhibited high cardiac index (4.11±1.15 1 · min-1 · m-2 vs 2.99±0.85 1 · min-1 · m-2; p<0.05) and low systemic vascular resistance (1039±316 dyn · s · cm-5 vs 1334±336 dyn · cm-5; p<0.05). The hepatic venous pressure gradient and hepatic blood flow were normal. Azygos blood flow was markedly increased (0.90±0.66 1 · min-1 vs 0.13±0.04 1 · min-1; p<0.05). Hemodynamic values were not significantly different between patients with liver fibrosis and those without fibrosis at liver biopsy. In conclusion, patients with hepatic schistosomiasis had a hyperkinetic systemic and splanchnic circulation. In patients with esophageal varices, a normal hepatic venous pressure gradient confirmed presinusoidal portal hypertension. The presence of portal or perisinusoidal fibrosis did not influence hyperdynamic splanchnic state.

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