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Effects of verapamil on hepatic and systemic hemodynamics and liver function in patients with cirrhosis and portal hypertension
Author(s) -
Navasa Miquel,
Bosch Jaime,
Reichen Jürg,
Bru Conxita,
Mastai Ricardo,
Zysset Thomas,
Silva Guillermo,
Chesta Jaime,
Rodés Joan
Publication year - 1988
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840080425
Subject(s) - verapamil , medicine , portal venous pressure , portal hypertension , cirrhosis , vascular resistance , hemodynamics , liver function , blood pressure , vasodilation , cardiology , gastroenterology , calcium
The effects of verapamil on hepatic and systemic hemodynamics and on liver function were investigated in 10 patients with portal hypertension due to advanced micronodular cirrhosis to verify whether, as it has been suggested, this calcium channel blocker may improve liver function and reduce portal pressure in these patients. The oral administration of 100 mg of verapamil caused systemic vasodilation, evidenced by a significant reduction in mean arterial pressure (−8.1 ± 7.6%, p < 0.025) and systemic vascular resistance (−12.5 ± 9.5%, p < 0.001), and increased heart rate (+13.9 ± 10.4%, p < 0.01). However, no beneficial effect was noted on portal pressure evaluated by hepatic vein catheterization (baseline 19.8 ± 4.0, verapamil 20.2 ± 3.6 mmHg, NS), hepatic blood flow (1.45 ± 0.64 vs. 1.47 ± 0.62 liters per min, NS) and hepatic vascular resistance (1.314 ± 611 vs. 1,266 ± 513 dyn per sec per cm −5 , NS). Similarly, no change was observed in portal blood flow, measured in six patients by pulsed Doppler flowmeter (0.94 ± 0.30 vs. 0.89 ± 0.35 liter per min, NS). In addition, verapamil did not increase the hepatic intrinsic clearance of these patients (0.20 ± 0.07 vs. 0.19 ± 0.06 liter per min, NS). This study suggests that verapamil is of no beneficial effect in patients with advanced cirrhosis of the liver.