ANEMIA WORSENS HYPERDYNAMIC CIRCULATION OF PATIENTS WITH CIRRHOSIS AND PORTAL-HYPERTENSION

This retrospective cohort study was aimed at investigating the effects of anemia on the hemodynamic disturbances associated with portal hype rtension. In all, 202 consecutive nontreated portal-hypertensive patie nts referred for evaluation to our Hepatic Hemodynamic Laboratory were included. Compared to the nonanemic patients, anemic cirrhotic patien ts had an increased cardiac output (7.9 +/- 1.9 vs 7.1 +/- 2 liters/mi n, P < 0.01), and a decreased mean arterial blood pressure (82 +/- 11 vs 94 +/- 13 mm Hg, P < 0.0001) and systemic vascular resistance (838 +/- 235 vs 1102 +/- 356 dyn/sec/cm(5), P < 0.0001). Similar results we re obtained when Child A or Child B-C patients were analyzed separatel y. Multivariate logistic regression disclosed that hemoglobin concentr ation, in addition to age, sex azygos blood flow, and albumin concentr ation, was an independent factor influencing the degree of systemic va sodilation in cirrhotic portal-hypertensive patients. This study discl oses that anemia worsens the hyperdynamic circulation associated with portal hypertension. Since hemoglobin concentration may change with ti me, this parameter should be taken into account when evaluating hemody namics in portal-hypertensive patients.