title: Portal venous flow in response to acute beta-blocker and vasodilatatory treatment in patients with liver cirrhosis.
abstract: The drugs currently under investigation in the prevention of recurrent gastrointestinal bleeding in cirrhosis are likely to decrease the portal pressure by means of a primary reduction of portal blood flow. The hemodynamic effects of beta-blocking agents and vasodilatory drugs were noninvasively measured in eight patients with cirrhosis by means of pulsed echo-doppler equipment. Portal caliber, blood velocity and flow were recorded hourly after a single dose of propranolol (40 mg p.o.) or atenolol (100 mg p.o.), and every 5 min after treatment with isosorbide dinitrate (5 mg sublingually). The drugs were administered at random with an interval of 2 days or more. The portal caliber decreased after atenolol, but did not change after propranolol and isosorbide. The blood velocity decreased by 29 +/- 2% 3 hr after propranolol, by 26 +/- 2% 3 hr after atenolol and by 31 +/- 3% 15 min after isosorbide. The portal blood flow decreased by 0.29 +/- 0.03 liters per min after propranolol, by 0.34 +/- 0.06 after atenolol and by 0.26 +/- 0.03 after isosorbide, without any difference among the various treatments. beta-blockers and vasodilatory drugs have comparable effects on portal blood flow. beta 1-selective and nonselective beta-blockers are similarly effective in keeping with the hypothesis that changes in portal blood flow are mainly due to the block of beta 1-receptors.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000187:drug effects; D004932:Esophageal and Gastric Varices / Q000188:drug therapy; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008102:Liver Circulation / Q000187:drug effects; D008103:Liver Cirrhosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D011433:Propranolol / Q000627:therapeutic use; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents; D001262:Atenolol; D011433:Propranolol; D007548:Isosorbide Dinitrate