Urine was collected for 24 hours. Patients were subsequently transferred to the Hepatic Hemodynamics Unit, and hemodynamics measurements were obtained. Subsequent to 2 hours after hemodynamics measurements, all study subjects underwent transthoracic echocardiography (TTE) to assess cardiac structure and systolic and diastolic function. Patients Caspase inhibition were discharged from the hospital with diuretics, norfloxacin, lactulose, or band ligation to prevent recurrence of ascites, SBP, hepatic encephalopathy (HE), and variceal bleeding, respectively. After discharge from the hospital, patients were followed up for at least 1 year in the outpatient clinic.
During follow-up, we performed an evaluation of all bacterial infections, variceal bleeding, HE, and type 1 HRS occurring in the patients included in the study. These patients were managed with standard therapy (Supporting Materials). FDA-approved Drug Library Patients transplanted during follow-up were considered as censored at the time of transplantation. Under fluoroscopic control, a Swan-Ganz catheter (Abbott Labs, Abbott Park, IL) was advanced into the pulmonary artery for measurement of cardiopulmonary pressures (right atrial pressure
[RAP], pulmonary artery pressure [PAP], and pulmonary capillary wedged pressure [PCWP]) and cardiac output (CO). A 7-F balloon-tipped catheter (MediTech Cooper Scientific Corp., Watertown, MA) was advanced into the main right hepatic vein to measure wedged and free hepatic venous pressures (WHVP and FHVP, respectively). Hepatic venous pressure gradient (HVPG) was calculated as the difference between WHVP and FHVP. All measurements 上海皓元医药股份有限公司 were performed in triplicate and the average taken. Heart rate and mean arterial pressure (MAP) were measured with an automatic sphygmomanometer. Systemic vascular resistance was calculated as follows: MAP (mmHg) − RAP (mmHg)/CO (L/min−1) × 80. Left ventricular stroke work was calculated as
follows: (stroke volume × [MAP − PCWP] × 0.0136) (g m-m). PRA, ALDO, NE, and ANF were determined as previously described. BNP was measured using a chemiluminometric immunoassay run on the ADVIA Centaur Immunochemistry analyzer (Siemens Healthcare Diagnostics, Tarrytown, NY). Values in healthy subjects on a low-sodium diet were as follows: 1.35 ± 0.94 ng/mL/hour, 24.2 ± 11.3 ng/dL, 253 ± 114 pg/mL, 6 ± 0.5 fmol/mL, and 25 ± 10 pg/mL, respectively. TTE was performed using commercially available instruments operating in a 2.5-5.0 MHz transducer in standard parasternal and apical views according to the recommendations of the American Society of Echocardiography (ASE). Calculations of different cardiac dimension and volumes were assessed by M-mode cursor. Left ventricular ejection fraction (LVEF) was obtained by a modified version of Simpson’s method.