title: [Addition of ritanserin to the treatment with propranolol in cirrhotic patients: effects on portal pressure].
abstract: The use of vasodilators to prevent the rupture of esophagic varices (EV) due to portal hypertension (PH) would reduce the portal pressure (PP) as the result of increased portocolateral flow. Rinsaterine, a 5-HT2 receptor blocker, reduces PP in experimental models of PH. This pilot study was designed to verify if ritanserine has a sustained and additive effect to propranolol on PP in cirrhotic patients with PH. Ten chronic patients with EV, under prophylactic therapy with propranolol and with a suprahepatic venous pressure gradient (SVPG) > 12 mm Hg, received ritanserine (0.11-0.14 mg/kg/day). One patients completed one month of treatment due to drug intolerance. Nine patients completed one month of treatment; SVPG did not show any significant variation in four patients and decreased 3 mm Hg in five patients, which were treated during 70 days more. After then, HVPG returned to its previous values except in one patient. The long-term association between ritanserine and propranolol does not improve the results of propranolol. However, the initial response observed in all of these patients supports the role of the serotoninergic system in the PH and states the need for further studies on 5-HT2 blocking for the prophylaxis of EV rupture.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario San Carlos, Universidad Complutense, Madrid.
authors.forename: J M
authors.initials: JM
authors.lastname: Ladero Quesada
authors.forename: S
authors.initials: S
authors.lastname: Díez Ordóñez
authors.forename: J J
authors.initials: JJ
authors.lastname: Gallego Beuter
authors.forename: A
authors.initials: A
authors.lastname: Hernández Lezana
authors.forename: M L
authors.initials: ML
authors.lastname: Herraiz Serrano
authors.forename: M
authors.initials: M
authors.lastname: Díaz-Rubio García
mesh_terms: D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy*; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D016713:Ritanserin / Q000627:therapeutic use*
chemical_list: D016713:Ritanserin; D011433:Propranolol
vernacular_title: Adición de ritanserina al tratamiento con propranolol en enfermos cirróticos: efectos sobre la presión portal.