PMID- 24373155
OWN - NLM
STAT- MEDLINE
DCOM- 20150528
LR  - 20140721
IS  - 1478-3231 (Electronic)
IS  - 1478-3223 (Linking)
VI  - 34
IP  - 7
DP  - 2014 Aug
TI  - Post-paracentesis circulatory derangements are related to monocyte activation.
PG  - 1001-7
LID - 10.1111/liv.12450 [doi]
AB  - BACKGROUND & AIMS: Post-paracentesis circulatory dysfunction is associated with 
      development of hepatorenal syndrome and increased mortality. The impact of large 
      volume paracentesis (LVP) on the 24-h blood pressure (BP) profile is unknown, and 
      the relationship to Na+-retentive and pro-inflammatory cytokines also remains 
      unknown. The aims of this study were to (i) define the effects of LVP with 
      albumin administration on 24-h BP profiles, and (ii) relate changes in BP over 
      time to changes in Na+-retentive hormones, clinical factors and inflammatory 
      cytokines. METHODS: Ten patients undergoing LVP had 24-h ambulatory BP monitoring 
      performed pre- and post-paracentesis. Markers of the innate immune system, 
      bacterial translocation and Na+-retentive hormones were drawn pre- and post-LVP. 
      RESULTS: Mean arterial pressure (MAP) dropped in nine of the 10 patients in the 
      24 h following a paracentesis compared to 24 h preceding the procedure (mean drop 
      of 5.5 mmHg, P<0.005). A mixed effects model was used to define time-covariate 
      interactions in predicting changes in BP profile. Monocyte chemotactic protein-1 
      (MCP1) was associated with Deltasystolic BP (beta=-0.011, P<0.05), Deltadiastolic BP 
      (beta=-0.012, P<0.05) and DeltaMAP (beta=-0.012, P<0.05). Plasma renin activity was also 
      significantly associated with Deltasystolic BP (beta=-0.21, P<0.05). Renal function was 
      also significantly reduced following LVP. CONCLUSIONS: Systolic, diastolic and 
      MAP decreased over 24 h after LVP compared to the 24 h pre-LVP. This drop is 
      related to increases in MCP-1 after LVP. Increased MCP-1, a marker of monocyte 
      activation, was strongly related to changes in BP.
CI  - (c) 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Carl, Daniel E
AU  - Carl DE
AD  - Division of Nephrology, Department of Internal Medicine, School of Medicine, 
      Virginia Commonwealth University (VCU), Richmond, VA, USA.
FAU - Ghosh, Siddharta
AU  - Ghosh S
FAU - Cheng, Jianfeng
AU  - Cheng J
FAU - Gehr, Todd W B
AU  - Gehr TW
FAU - Stravitz, R Todd
AU  - Stravitz RT
FAU - Sanyal, Arun
AU  - Sanyal A
LA  - eng
GR  - UL1TR000058/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20140303
PL  - United States
TA  - Liver Int
JT  - Liver international : official journal of the International Association for the 
      Study of the Liver
JID - 101160857
RN  - 0 (Cytokines)
RN  - 0 (Serum Albumin)
RN  - EC 3.4.23.15 (Renin)
SB  - IM
CIN - Liver Int. 2014 Aug;34(7):974-5. PMID: 24661840
MH  - Ascites/etiology/*surgery
MH  - Blood Pressure/physiology
MH  - Cytokines/blood
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Kidney/metabolism/physiology
MH  - Liver Cirrhosis/*complications/pathology
MH  - Male
MH  - Middle Aged
MH  - Monocytes/*physiology
MH  - Paracentesis/*adverse effects
MH  - Prospective Studies
MH  - Renin/blood
MH  - Serum Albumin/pharmacology
MH  - Shock/*etiology/*physiopathology/prevention & control
MH  - Vasodilation/physiology
MH  - Virginia
OTO - NOTNLM
OT  - 24-h ambulatory blood pressure monitoring
OT  - cirrhosis
OT  - inflammation
OT  - paracentesis
EDAT- 2014/01/01 06:00
MHDA- 2015/05/29 06:00
CRDT- 2013/12/31 06:00
PHST- 2013/10/22 00:00 [received]
PHST- 2013/12/15 00:00 [accepted]
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2015/05/29 06:00 [medline]
AID - 10.1111/liv.12450 [doi]
PST - ppublish
SO  - Liver Int. 2014 Aug;34(7):1001-7. doi: 10.1111/liv.12450. Epub 2014 Mar 3.