title: Noninvasive measurement of femoral blood flow and portal pressure response to propranolol in patients with cirrhosis.
abstract: This study investigated the correlation between changes in hepatic and systemic hemodynamics and femoral blood flow (FBF), measured by dual-beam pulsed wave Doppler, in 58 portal hypertensive patients receiving propranolol (0.15 mg/Kg intravenously; n = 44) or placebo (n = 14) under double-blind conditions. Placebo administration had no effects. Propranolol caused significant reductions (P < .0001) in hepatic venous pressure gradient (HVPG; from 19.1 +/- 4.1 to 16.2 +/- 4.2 mm Hg), azygos blood flow (from 563 +/- 204 to 387 +/- 176 mL/min), cardiac index (CI; from 4.4 +/- 1.0 to 3.3 +/- 0.8 L/m2/min), and FBF (from 237 +/- 79 to 176 +/- 58 mL/m2/min). In 17 patients HVPG decreased below 12 mm Hg and/or more than 20% of the baseline value (good response; mean change, -26 +/- 8%); in the remaining 27 patients (poor response) the mean change in HVPG was less: -9 +/- 6%. Patients with a good response had bled less often from varices, had significantly higher FBF (272 +/- 73 vs. 215 +/- 76 mL/m2/min) and lower baseline HVPG (16.8 +/- 3.9 vs. 20.6 +/- 3.6 mm Hg) than those with poor response in HVPG. The good response was also associated with greater decreases in FBF (-33 +/- 12 vs. -19 +/- 13% in poor responders), CI (-30 +/- 9 vs. -19 +/- 12%), and heart rate (-19 +/- 5 vs. -16 +/- 6%). A decrease in FBF of > 20% predicted a good response in 16 of 28 patients (positive predictive value, 57%).(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Hepatic Hemodynamic Laboratory, Hospital Clínic i Provincial, University of Barcelona, Spain.
authors: A
authors: A
authors: Luca
authors: J C
authors: JC
authors: García-Pagán
authors: F
authors: F
authors: Feu
authors: J C
authors: JC
authors: Lopez-Talavera
authors: M
authors: M
authors: Fernández
authors: C
authors: C
authors: Bru
authors: J
authors: J
authors: Bosch
authors: J
authors: J
authors: Rodés
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006503:Hepatic Veins / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011433:Propranolol / Q000627:therapeutic use*; D012039:Regional Blood Flow; D014463:Ultrasonography; D014690:Venous Pressure / Q000187:drug effects*
chemical_list: D011433:Propranolol