Changes in hepatic circulation at rest, during and after exercise in young males with infectious hepatitis compared with controls.

Abstract

Abstract. Hepatic venous catheterization has been performed in 10 young males with infectious hepatitis and 13 healthy male volunteers. Hepatic blood flow at rest in the supine position, estimated with indocyanine green dye in constant infusion, was significantly higher in the patients than in the controls (2.21 and 1.44 l/min, respectively). During supine leg exercise with heart rates about 170 beats/min the absolute reduction of total hepatic blood flow was similar in patients and controls. The arterio‐hepatic venous oxygen difference during exercise as compared with that at rest was doubled in the patients, but tripled in the controls. The splanchnic oxygen uptake at rest was significantly higher in the patients than in the controls and did not change significantly during exercise. At rest the patients had a significantly greater difference between wedged and free hepatic venous pressure than the controls, possibly due to swelling of the hepatocytes. The hyperkinetic hepatic circulation might have been caused by cellular damage and blood flow impairment with anoxia and a metabolically evoked vasodilatation and also by an increased regeneration of liver cells, as splanchnic oxygen uptake was elevated. Immunologic factors may also have contributed. No negative effects of the exercise were noted in 8 patients with serum bilirubin values below 4 mg/100 ml, whereas a relapse and a slightly delayed recovery were noted in 2 patients with serum bilirubin values of 9.6 and 5.8 mg/100 ml, respectively.