PMID: 9551683Apr 29, 1998Paper

Upright posture decreases esophageal varices flow velocity in patients with cirrhosis

Journal of Hepatology
T IwaoK Tanikawa

Abstract

Patients with cirrhosis tend to have esophageal variceal bleeding episodes at night, rather than during the day time. Since human beings carry on ordinary activities in the upright posture in the day time and are recumbent at night, we hypothesized that posture may be a factor related to a circadian variation of variceal bleeding. The aim of this study was to examine the effect of upright posture on esophageal varices hemodynamics in patients with cirrhosis. Nine patients with cirrhosis and esophageal varices were included in a crossover study performed on 2 separate days. On the non-endoscopic day, cardiac output, portal vein flow velocity, and superior mesenteric artery flow velocity were measured with percutaneous Doppler ultrasonography. Plasma renin activity and plasma norepinephrine concentrations were also determined. On the endoscopic day, in addition to the above measurements, esophageal varices flow velocity was measured using transesophageal Doppler ultrasonography. These measurements were performed in the supine position and 20 min after the assumption of the upright position. On the non-endoscopic day, the upright posture significantly decreased cardiac output, portal vein flow velocity, and superior mesenteric art...Continue Reading

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Citations

Jun 1, 2009·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Salah ArefMohammed El Refaie
Feb 27, 2003·Ultrasound in Medicine & Biology·Shoichi MatsutaniHiromitsu Saisho
May 25, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Florence WongLaurence Blendis
Jan 21, 2010·The Journal of Surgical Research·Jason SchwartzJean-Marc Lalouel
Jul 14, 2000·The American Journal of Gastroenterology·J GenescaJ Guardia
Dec 6, 2007·Journal of Clinical Gastroenterology·Reiner Wiest

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