RELATIONSHIPS BETWEEN THE SEVERITY OF CIRRHOSIS AND HEMODYNAMIC VALUES IN PATIENTS WITH CIRRHOSIS

The relationship between the severity of cirrhosis and systemic and he patic haemodynamic values was evaluated in 193 patients with cirrhosis , most of whom were diagnosed with post-necrotic cirrhosis. It was fou nd that the hepatic venous pressure gradient and cardiac output in Pug h's A patients (13.6 +/- 4.8 mmHg and 6.2 +/- 1.6 L/min, mean +/- s.d. ) were significantly lower than in both Pugh's B (16.8 +/- 4.3 mmHg an d 7.3 +/- 2.1 L/min) and Pugh's C (18.8 +/- 5.5 mmHg and 7.4 +/- 2.3 L /min) patients (P < 0.01), respectively. In contrast, the systemic vas cular resistance in Pugh's A patients (1232 +/- 369 dyn/s per cm(5)) w as significantly higher than in both Pugh's B (1016 +/- 345 dyn/s per cm(5)) and Pugh's C (935 +/- 234dyn/s per cm(5)) patients (P < 0.01), respectively. Additionally, not only was there a positive correlation found between Pugh's score and cardiac output and hepatic venous press ure gradient, but a negative correlation was found between Pugh's scor e and systemic vascular resistance. It was also confirmed that the deg ree of portal hypertension and the hyperdynamic circulation were more severe in patients with ascites than in those without ascites. However , there were no statistically significant differences in hepatic venou s pressure gradient among patients with F1, F2 and F3 esophageal varic es (15.7 +/- 4.0, 17.0 +/- 4.8 and 18.0 +/- 4.8 mmHg, respectively). I t is concluded that in those patients with cirrhosis, the severity of cirrhosis is closely related to the degree of the hyperkinetic circula tory state and portal hypertension.