Effect of Propranolol on Portal Pressure and Systemic Hemodynamics in Patients with Liver Cirrhosis and Portal Hypertension: A Prospective Study.
- Author:
Ki Tae SUK
1
;
Moon Young KIM
;
Dong Hun PARK
;
Kyu Hong KIM
;
Ki Won JO
;
Jin Hon HONG
;
Jae Woo KIM
;
Hyun Soo KIM
;
Sang Ok KWON
;
Soon Koo BAIK
Author Information
1. Department of Internal Medicine and Institute of Lifelong Health, Yonsei University Wonju College of Medicine, Wonju, Korea. baiksk@medimail.co.kr
- Publication Type:Original Article
- Keywords:
Propranolol;
Portal hypertension;
Liver cirrhosis;
Pressure
- MeSH:
Blood Pressure;
Dizziness;
Esophageal and Gastric Varices;
Fibrosis;
Heart Rate;
Hemodynamics*;
Humans;
Hypertension, Portal*;
Liver Cirrhosis*;
Liver*;
Portal Pressure*;
Propranolol*;
Prospective Studies*;
Venous Pressure
- From:Gut and Liver
2007;1(2):159-164
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Propranolol can prevent variceal bleeding by ameliorating portal hypertension. We conducted this study to determine the effect of propranolol on portal hypertension and the optimal required dose in Korean cirrhotic patients. METHODS: This study prospectively evaluated 50 patients with cirrhosis who exhibited variceal bleeding. The hepatic venous pressure gradient (HVPG), portal venous flow, heart rate (HR), and blood pressure were assessed both at baseline and at 3 months after the treatment. The initial dose of propranolol (20 mg) was subsequently adjusted until the target HR was reached. Patients in whom HVPG reduced by >20% or to less than 12 mmHg were defined as responders. RESULTS: Propranolol significantly (p<0.01) reduced the HVPG (-21+/-26%, mean+/-standard deviation), portal venous flow (-25+/-21%), HR (-20+/-13%), and blood pressure (-3+/-13%). Twenty-nine patients were responders, and the optimal required dose was 154.4 mg. The main complication was dizziness (24%), but this was not serious enough to require medication withdrawal. CONCLUSIONS: Propranolol is safe and effective at reducing portal pressure in Korean cirrhotic patients. An effective improvement in portal hypertension requires the dose to be increased until the target HR is reached.
