Study of the portal hemodynamic changes induced by catecholamine in man

Abstract

We used the Doppler duplex system to investigate changes in the portal hemodynamics of healthy adults and patients with chronic liver disease (chronic hepatitis and liver cirrhosis) induced by infusion of dobutamine into the peripheral vein at rates of 2, 3 and 5μg/kg/min. The blood flow in portal, splenic, and superior mesenteric veins of both patients with chronic hepatitis and healthy adults significantly increased during infusion of dobutamine. The average change in blood flow in patients with liver cirrhosis did not however change statistically.
The mean arterial pressure in healthy adults increased significantly during infusion of dobutamine. However, that in patients with liver cirrhosis did not change. The heart rate in patients with chronic liver disease increased significantly. However, that in healthy adults did not show statistical change.
There are two possible explanations for the difference in the effect of dobutamine between these three groups: One is that many patients with liver cirrhosis have extrahepatic portosystemic shunts, thus the increase of portal venous inflow bypasses the liver into the systemic circulation through the portosystemic shunts; the other is that the hyperdynamic circulatory state in patients with chronic liver disease modifies the changes in portal circulatory system induced by dobutamine.