title: Effect of propranolol on portosystemic collateral circulation estimated by per-rectal portal scintigraphy with technetium-99m pertechnetate.
abstract: OBJECTIVE
  Propranolol is widely used in the prevention of variceal bleeding. However, in certain patients with cirrhosis, the portal hypotensive effect of propranolol cannot be obtained. An explanation for portal unresponsiveness to propranolol could be an increase in portocollateral vascular resistance mediated by this drug.
  
  
  METHODS
  In 33 patients with cirrhosis the effect of chronic administration of propranolol on portocollateral blood flow from the inferior mesenteric vein was examined by means of per-rectal portal Tc-99m pertechnetate scintigraphy.
  
  
  RESULTS
  Propranolol significantly reduced the shunt index by 15.3 +/- 4.2%. This reduction was observed only in patients with cirrhosis classified as Child-Pugh A and B groups, but not group C. Differences between groups in portosystemic shunt index changes after propranolol were significant (F = 3.4, p < 0.05).
  
  
  CONCLUSIONS
  The data presented suggest that propranolol changes the distribution of blood between the portal and systemic circulation, which is probably due to the increase in vascular resistance of portocollateral vessels. The magnitude of the vascular response to propranolol depends on the severity of liver disease.
authors.affiliation: Department of Gastroenterology, Silesian Medical School, Katowice, Poland.
authors.forename: H
authors.initials: H
authors.lastname: Bołdys
authors.forename: M
authors.initials: M
authors.lastname: Hartleb
authors.forename: K
authors.initials: K
authors.lastname: Rudzki
authors.forename: A
authors.initials: A
authors.lastname: Nowak
authors.forename: S
authors.initials: S
authors.lastname: Nowak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003097:Collateral Circulation / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging* / Q000187:drug effects*; D011433:Propranolol / Q000494:pharmacology*; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D013997:Time Factors
chemical_list: D011433:Propranolol; D013670:Sodium Pertechnetate Tc 99m