Clinical Studies Of Valsartan On Portal Hypertension In Patients With Hepatic Cirrhosis

Object: To study the mechanism of valsartan in reducing portal hypertension by observing the effects of valsartan on hemodynamic markers, calcitonin gene related peptide (CGRP), hyaluronicacid (HA), cholyglycine (CG) and plasminogen activator inhibitor-1 (PAI-1) in patients with hepatic cirrhosis.Methods: Thirty-six patients with hepatic cirrhosis were divided into control group and observation group randomly. The control group (18) received routine treatment for 1 month and eighteen patients in observation group received valsartan 80 mg/day based on routine treatment for the same time. Diameter of portal or splenic vein and their mean velocity were measured before and after treatment by ultrasonography. Blood levels of CGRP, HA and CG were simultaneously assessed by radioimmunoassay. PAI-1 was measured by ELISA and all the data were statistically analyzed.Results: 1) Valsartan reduced the diameter of portal or splenic vein and increased the mean velocity of portal or splenic vein. The differences is significant statistically(P<0.05)after treatment in observation group , but no significance in control group.2) Valsartan treatment decreased the concentration of CGRP in observation group (75.79±15.06 vs 73.15±14.59) and the difference was significant statistically(P<0.05), but in routine treatment CGRP was not significantly decreased.3) The concentration of HA, CG and PAI-1 were significantly decreased after the valsartan treatment (498.39±197.53 vs 422.34±183.94, 24.23±13.05 vs 12.50±8.92, 32.56±11.18 vs 28.09±10.80, P < 0.05) while not in control group.Conclusion: 1) Valsartan could decrease portal hypertension by reducing the diameter of portal or splenic vein and increasing its mean velocity.2) Valsartan could ameliorate hyperdynamic circulatory state (HCS) in patients with hepatic cirrhosis by decreasing the concentration of CGRP.3) Valsartan may have the effect of anti-hepatic fibrosis by reducing the level of HA, CG and PAI-1 in blood and furthermore lower the portal hypertension indirectly.