RELATIONSHIP BETWEEN GASTRIC-MUCOSAL CHANGES AND HEMODYNAMIC PATTERNSIN ALCOHOLIC CIRRHOSIS - A PROSPECTIVE-STUDY

Most gastric mucosal changes in cirrhosis are thought to be related to vasculopathy. The aim of this study was to determine whether there wa s a relationship between gastric mucosal changes and hemodynamic in ci rrhosis. Thirty patients with alcoholic cirrhosis were divided into fo ur groups: no congestive gastropathy (n = 6), mild congestive gastropa thy type 1 (discrete mosaic pattern) (n = 9), mild congestive gastropa thy type 2 (obvious mosaic pat-tern) (n = 9), and severe congestive ga stropathy (n = 6). The four groups did not significantly differ with r espect to clinical and biochemical data, degree of hepatic dysfunction , or endoscopic signs of portal hypertension. A hyperdynamic circulato ry syndrome was observed in most patients, but tended to be more prono unced in patients with severe congestive gastropathy and mild congesti ve gastropathy type 2 as compared to patients with normal mucosa, or m ild congestive gastropathy type 1. Systemic vascular resistance was fo und to be slgnificantly lower in high-grade patients (mild congestive gastropathy type 2 + severe congestive gastropathy, n = 15) as compare d with low-grade patients (no congestive gastropathy + mild congestive gastropathy type 1, n = 15) (736 +/- 267 vs 1 046 +/- 403 dyne.s.cm-5 , P = 0.02). Neither splanchnic hemodynamics as assessed by the degree of portal hypertension (hepatic venous pressure gradient) and superio r mesenteric artery vascular resistance (Doppler measurement of the pu lsatility index) catecholamines or glucagon serum levels differed sign ificantly between the four groups. In conclusion, the severity of gast ric mucosal changes in alcoholic cirrhosis tend to be related to the m agnitude of hyperkinetic circulation, but not to the degree of portal hypertension nor to the severity of liver disease.