[Effects of sotalol on blocked suprahepatic pressure in cirrhotic patients].
With the use of two balloon catheters inserted in the right jugular vein, the following parameters were measured before and after injection of sotalol (1.5 mg/kg): cardiac output with the thermodilution method, hepatic output with the indocyanin green perfusion method, free sub-hepatic pressure, blocked sub-hepatic pressure recorded at rest and during coughing. After 30 minutes, the following modifications were recorded: the cardiac output goes from 6.8 +/- 2.1 to 5.9 +/- 1.9 L/min (NS), the hepatic output goes from 1.9 +/- 1.1 to 1.5 +/- 0.6 L/min (NS), the hepatic pressure gradient goes from 18.2 +/- 6.1 to 11.5 +/- 5.4 mmHg (p less than or equal to 0.0005); the blocked sus-hepatic pressure at rest goes from 25.0 +/- 7.8 to 19.8 +/- 8.0 mmHg (p less than or equal to 0.025); the blocked sus-hepatic pressure during coughing goes from 92 +/- 32 to 82 +/- 39 mmHg (NS). This study demonstrates: a) that the drop in the hepatic pressure gradient induced by a dose of sotalol is more important than that observed by Westaby et al. with propranolol: 37% vs 31% (NS); b) that sotalol cannot lower the blocked sub-hepatic pressure during coughing. This result suggests that the potential protective effect of sotalol toward esophageal varices rupture disappears during coughing.
Département de Clinique et Pathologie Médicales, Université de Liége, Belgique.
J
J
Deflandre
V
V
Gillard
J
J
Pirotte
D
D
el Allaf
J
J
Carlier
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002302:Cardiac Output / Q000187:drug effects; D003371:Cough; D005260:Female; D006503:Hepatic Veins / Q000187:drug effects*; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000494:pharmacology / Q000627:therapeutic use; D013015:Sotalol / Q000494:pharmacology* / Q000627:therapeutic use
D011433:Propranolol; D013015:Sotalol
Effets du sotalol sur la pression sus-hépatique bloquée de malades cirrhotiques.