Relationships between types of esophagogastric varices and systemic hemodynamics in patients with liver cirrhosis.

ABSTRACT

BACKGROUND/AIMS: To investigate the relationships between the types of esophagogastric varices and systemic hemodynamics in patients with liver cirrhosis. METHODOLOGY: Fifty-three patients with esophagogastric varices were included in this study and divided into 4 groups according esophagogastric varices type. Groups 1 and 2 were medium-size (F2-EV) and large-size esophageal varices (F3-EV), respectively. Groups 3 and 4 were medium-size (F2-GV) and large-size isolated gastric varices (F3-GV), respectively. RESULTS: The cardiac indexes (CI) were 3.61 +/- 0.76, 4.65 +/- 1.11, 3.78 +/- 0.69 and 4.65 +/- 0.75 in groups 1 to 4, respectively. CI in patients with F3 varices (groups 2 and 4) were significantly higher than those in patients with F2 varices (groups 1 and 3) (p<0.01). The systemic vascular resistances (SVRI) were 2140 +/- 623, 1463 +/- 473, 1916 +/- 420 and 1504 +/- 250 in groups 1 to 4, respectively. SVRI in patients with F3 varices were significantly lower than those in patients with F2 varices (p<0.01). Plasma ammonia levels (NH3) were 78 +/- 27, 162 +/- 153, 80 +/- 27 and 138 +/- 71 in groups 1 to 4, respectively. NH3 in patients with F3 varices were significantly higher than those in patients with F2 varices (p<0.01). The arterio-venous oxygen content differences (Ca-vO2) were 2.93 +/- 0.60, 2.53 +/- 0.55, 2.67 +/- 0.54 and 2.32 +/- 0.64 in groups 1 to 4, respectively. CONCLUSIONS: We conclude that the development of esophagogastric varices is accompanied by deteriorated liver function, hyperdynamic status, increased NH3 and narrowed Ca-vO2.