Original Article
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2014; 20(45): 17065-17074
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.17065
Correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis
Hideaki Takahashi, Ryuta Shigefuku, Yoshihito Yoshida, Hiroki Ikeda, Kotaro Matsunaga, Nobuyuki Matsumoto, Chiaki Okuse, Shigeru Sase, Fumio Itoh, Michihiro Suzuki
Hideaki Takahashi, Ryuta Shigefuku, Yoshihito Yoshida, Hiroki Ikeda, Kotaro Matsunaga, Nobuyuki Matsumoto, Chiaki Okuse, Fumio Itoh, Michihiro Suzuki, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
Hideaki Takahashi, Division of Gastroenterology, Department of Internal Medicine, Sapporo Shirakabadai Hospital, Sapporo 062-0052, Japan
Hideaki Takahashi, Department of Molecular Biology, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
Shigeru Sase, Anzai Medical Co., Ltd., Tokyo 141-0033, Japan
Author contributions: Takahashi H and Shigefuku R contributed equally to this article; Takahashi H contributed to the study concept and design; Takahashi H, Shigefuku R, Yoshida Y, Ikeda H, Matsunaga K, Matsumoto N, Okuse C, Sase S, Itoh F and Suzuki M contributed to the acquisition of data; Takahashi H, Shigefuku R and Yoshida Y contributed to the analysis and interpretation of data; Takahashi H drafted the article or revised it critically for important intellectual content; Takahashi H and Shigefuku R contributed to the statistical analysis.
Correspondence to: Hideaki Takahashi, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki 216-8511, Japan. hide-bo@marianna-u.ac.jp
Telephone: +81-44-9765805 Fax: +81-44-9765805
Received: January 6, 2014
Revised: March 31, 2014
Accepted: April 27, 2014
Published online: December 7, 2014
Processing time: 337 Days and 23.8 Hours
Abstract

AIM: To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis (AL-LC).

METHODS: The subjects included 35 patients with AL-LC (34 men, 1 woman; mean age, 58.9 ± 10.7 years; median age, 61 years; range: 37-76 years). All patients were enrolled in this study after obtaining written informed consent. Liver function was measured with tests measuring albumin (Alb), prothrombin time (PT), brain natriuretic peptide (BNP), branched amino acid and tyrosine ratio (BTR), branched chain amino acid (BCAA), tyrosine, ammonia (NH3), cholinesterase (ChE), immunoreactive insulin (IRI), total bile acid (TBA), and the retention rate of indocyanine green 15 min after administration (ICG R15). Hepatic blood flow, hepatic arterial tissue blood flow (HATBF), portal venous tissue blood flow (PVTBF), and total hepatic tissue blood flow (THTBF) were simultaneously calculated using xenon computed tomography.

RESULTS: PVTBF, HATBF and THTBF were 30.2 ± 10.4, 20.0 ± 10.7, and 50.3 ± 14.9 mL/100 mL/min, respectively. Alb, PT, BNP, BTR, BCAA, tyrosine, NH3, ChE, IRI, TBA, and ICG R15 were 3.50 ± 0.50 g/dL, 72.0% ± 11.5%, 63.2 ± 56.7 pg/mL, 4.06 ± 1.24, 437.5 ± 89.4 μmol/L, 117.7 ± 32.8 μmol/L, 59.4 ± 22.7 μg/dL, 161.0 ± 70.8 IU/L, 12.8 ± 5.0 μg/dL, 68.0 ± 51.8 μmol/L, and 28.6% ± 13.5%, respectively. PVTBF showed a significant negative correlation with ICG R15 (r = -0.468, P <0.01). No significant correlation was seen between ICG 15R, HATBF and THTBF. There was a significant correlation between PVTBF and Alb (r = 0.2499, P < 0.05), and NH3 tended to have an inverse correlation with PVTBF (r = -0.2428, P = 0.0894). There were also many significant correlations between ICG R15 and liver function parameters, including Alb, NH3, PT, BNP, TBA, BCAA, and tyrosine (r = -0.2156, P < 0.05; r = 0.4318, P < 0.01; r = 0.4140, P < 0.01; r = 0.3610, P < 0.05; r = 0.5085, P < 0.001; r = 0.4496, P < 0.01; and r = 0.4740, P < 0.05, respectively).

CONCLUSION: Our investigation showed that there is a close correlation between liver function and hepatic blood flow.

Keywords: Alcoholic liver cirrhosis; Hepatic tissue blood flow; Liver function; Indocyanine green; Xenon computed tomography

Core tip: Hepatic blood flow (HBF) generally decreases with disease progression in chronic liver disease. Additionally, collateral vessels appear and liver function, such as liver synthesis and disposal capability, declines in liver cirrhosis (LC). Notably, in LC it is known that liver function deteriorates in almost direct proportion to progression of liver disease parameters such as Child-Pugh classification. Thus, in order to assess the state of chronic liver disease it is very important to evaluate HBF. The aim of the present study was to measure liver function and HBF using xenon computed tomography, and to elucidate the correlation between HBF and liver function in alcoholic LC.