Vasopressin-nifedipine: a favourable haemodynamic interaction in cirrhosis and portal hypertension

Objective: To assess the acute splanchic and systemic haemodynamic effects of the vasodilator calcium channel blocker, nifedipine, alone and combined with vasopressin in six patients with alcoholic cirrhosis. Design: Splanchic and systemic haemodynamics were determined before and after vasopressin infusion, during a washout period, after sublingual nifedipine and again following the re-infusion of vasopressin. Methods: Haemodynamic assessment was performed by hepatic vein and pulmonary artery catheterization. Liver blood flow was measured by the continuous indocyanine green infusion method. Results: Vasopressin alone reduced the hepatic venous pressure gradient (HVPG), while mean pulmonary artery pressure (PAP) and pulmonary capillary wedge pressure (PCWP) were increased