Systemic hemodynamics in non-cirrhotic portal hypertension--a clinical study of 19 patients

The features of systemic hemodynamics were analyzed in 19 non-cirrhotic patients with prominent esophageal varices. The patients were divided into two groups; Group I comprised 8 patients with an occluded extra-hepatic portal vein and Group II comprised 11 patients with a patent extra-hepatic portal vein whose histopathological diagnosis was idiopathic portal hypertension or hepatic fibrosis. An increase in the cardiac index and a decrease in the total peripheral resistance were significant in both groups when compared with 12 control patients (p less than 0.01). There was a significant correlation between the cardiac index and plasma volume in the 14 non-cirrhotic patients with portal hypertension (r = 0.537, p less than 0.05), but no significant relationships were identified between the cardiac index and liver functional values. These results reveal that the systemic hemodynamics in non-cirrhotic portal hypertension are significantly hyperdynamic, as in cirrhotic portal hypertension. They also suggest that the expanded plasma volume secondary to the enlargement of the portal bed might be closely related to the mechanism of hyperdynamic systemic circulation in non-cirrhotic portal hypertension.