Hemodynamic effect of propranolol on portal hypertension in patients with HBsAg-positive cirrhosis
Tóm tắt
Wedged hepatic venous pressure, free hepatic venous pressure, and cardiac index were measured before and one hour after intravenous and one month after chronic oral administration of propranolol in nine patients with HBsAg-positive cirrhosis. The gradient between wedged hepatic venous pressure and free hepatic venous pressure was decreased 22.7% at one hour after intravenous administration of 5 mg propranolol, and a sustained decrease in hepatic venous pressure gradient was also demonstrated in five patients after one month of continuous oral administration of propranolol. Thus, we conclude that chronic oral administration of propranolol can reduce the hepatic venous pressure gradient in patients with compensated HBsAg-positive cirrhosis.
Tài liệu tham khảo
Boyer TD, Triger DR, Horisawa M, Redeker AG, Reynolds TB: Direct transhepatic measurement of portal vein pressure using a thin needle comparison with wedged hepatic vein pressure. Gastroenterology 72:584–589, 1977
Groszmann RJ, Glickman M, Blei AT, Storer E, Conn HO: Wedged and free hepatic venous pressure measured with a balloon catheter. Gastroenterology 76:253–258, 1979
Lebrec D, Hillon P, Munoz C, Goldfarb G, Nouel O, Benhamou JP: The effect of propranolol on portal hypertension in patients with cirrhosis: A hemodynamic study. Hepatology 2:523–527, 1982
Bosch J, Kravetz D, Rodes J: Effect of somatostatin of hepatic and systemic hemodynamics in patients with cirrhosis of the liver: Comparison with vasopressin. Gastroenterology 80:518–525, 1981
Groszmann RJ, Kravetz D, Bosch J, Glickman M, Bruix J, Bredfeldt J, Conn HO, Rodes J, Storer EH: Nitroglycerin improves the hemodynamic response to vasopressin in portal hypertension. Hepatology 2:757–762, 1982
Lo KJ, Tong MJ, Chien MC, Tsai YT, Liaw YFK, Yang KC, Chian H, Liu HC, Lee SD: The natural course of hepatitis B surface antigen-positive chronic active hepatitis in Taiwan. J Infect Dis 146:205–210, 1982
Valla D, Bercoff E, Menu Y, Bataille C, Lebrec D: Discrepancy between wedged hepatic venous pressure and portal venous pressure after acute propranolol administration in patients with alcoholic cirrhosis. Gastroenterology 86:1400–1403, 1984
Bosch J, Kravetz D, Mastai R, Bruix J, Rigau J, Rodes J: Azygos venous blood flow in cirrhosis: Effects of balloon tamponade, vasopressin, somatostatin, and propranolol. Hepatology 3:855, 1983 (abstract)
Nakayama T, Ohnishi K, Saito M, Hatano J, Nomura F, Kono K, Okuda K: Effects of propranolol on portal vein pressure, portal blood flow, hepatic blood flow and cardiac output in patients with chronic liver disease. Hepatology 3:812, 1983 (abstract)
Boyer TD, Trigger DR, Horisawa M, Redeker AG, Reynokls TB: Direct transhepatic measurement of portal vein pressure using a thin needle comparison with wedged hepatic vein pressure. Gastroenterology 72:584–589, 1977
Pomier-Layrargues G, Kvsielewicz D, Willems B, Villeneuve JP, Marleav D, Cote J, Huet PM: Presinusoidal portal hypertension in non-alcoholic cirrhosis. Hepatology 5:415–418, 1985
Hillon P, Lebrec D, Munoz C, Jungers M, Goldfrab G, Benhamou JP: Comparison of the effects of cardioselective and a nonselective beta-blocker on portal hypertension in patients with cirrhosis. Hepatology 2:528–531, 1982
Kroeger RJ, Groszmann RJ: Increased portal venous resistance hinders portal pressure correction during the administration of adrenergic blocking agents in portal hypertensive model. Hepatology 5:97–101, 1985
Hillon P, Blanchet L, Lebrec D: Effect of propranolol on hepatic blood flow in normal and portal hypertensive rats. Clin Sci 63:29–32, 1982
Groszmann RJ, Koreger RJ: Normalization of portal blood flow but not portal pressure during the administration of Beta-adrenergic blocking agents in a portal hypertensive model. Hepatology 4:760, 1984 (abstract)
Braillon A, Jiron MI, Valla D, Cales P, Lebrec D: Redistribution of cardiac output to the liver in patients with cirrhosis receiving propranolol. Hepatology 4:760, 1984 (abstract)
Bosch J, Masti R, Kravetz D, Bruix J, Gaya J, Rigau J, Rodes J: Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis. Hepatology 4:1200–1205, 1984
Ohishi K, Nakayama T, Saito M, Hatano H, Tsukamoto T, Terabayashi H, Sugita S, Wada K, Nomura F, Koen H, Okuda K: Effects of propranolol on portal hemodynamics in patients with chronic liver disease. Am J Gastroenterol 80:132–135, 1985
Groszmann RJ: Reassessing portal venous pressure measurements. Gastroenterology 86:1611–1617, 1984 (editorial)
Rector WG: Propranolol for portal hypertension. Hepatology 2:678, 1982 (abstract)
Conn HO: Propranolol in the treatment of portal hypertension: A caution. Hepatology 2:641–644, 1982
Lebrec D, Nouel O, Coric M: Propranolol-A medical treatment for portal hypertension. Lancet 2:180–182, 1980
Lebrec D, Poynard T, Hillon P, Benhamou JP: Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: A controlled study. N Engl J Med 305:1371–1374, 1981
Lebrec D, Poynard T, Bernuau J, Bercoff E, Nouel O, Capron JP, Poupon R, Bouvry M, Rueff B, Benhamou JP: A randomized controlled study of propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a final report. Hepatology 4:355–358, 1984