EFFECT OF VERAPAMIL ON PORTAL AND SPLANCHNIC HEMODYNAMICS IN PATIENTSWITH ADVANCED POSTHEPATITIC CIRRHOSIS USING DUPLEX-DOPPLER ULTRASOUND

Purpose: To assess the effect of verapamil (80 mg) oral administration on portal and splanchnic hemodynamics in patients with advanced posth epatitic cirrhosis using duplex Doppler ultrasound (US). Methods: Four teen patients with post-hepatitic liver cirrhosis were included in the study. Duplex Doppler sonographic examinations were performed before, and 2-3 h after, 80 mg verapamil oral administration. Portal and spla nchnic hemodynamics including vessel diameters (mm), mean flow velocit ies (cm/s), blood flows (ml/min), Doppler indices such as pulsatility and resistive indices (PI and RI), were investigated before and after verapamil administration. Results: After verapamil administration; dia meter of portal vein, splenic vein, and superior mesenteric artery (SM A) showed increase of 8%, 10%, and 7% (P < 0.05 to < 0.001), respectiv ely. Increases of 20%, 38%, and 47% were found in blood flows (P < 0.0 5 to < 0.0001) with respect to the above vessels. Decreases of 17%, 10 %, 11%, and 7% were found in SMA PI, SMA RI, splenic artery (SA) PI, a nd SA RI, respectively (P < 0.05 to < 0.0001). Conclusions: Verapamil appears to have splanchnic, portal, splenic, portocollateral and proba bly intrahepatic vasodilator effects in patients with advanced posthep atitic liver cirrhosis. Verapamil should be further investigated in th e treatment of patients with advanced liver cirrhosis with prospective studies measuring portal and wedged hepatic pressure.