Duplex Doppler ultrasonographic comparison of the effects of propranolol and isosorbide-5-mononitrate on portal hemodynamics.
Eighteen cirrhotic patients with esophageal varices at risk for bleeding took part in a double-blind study. The variations in PFV induced by either 40 mg of propranolol or 60 mg of sustained-release isosorbide-5-mononitrate on two consecutive days were evaluated with a duplex Doppler device. Both drugs caused a significant decrease in maximum (propranolol, P = 0.002; isosorbide-5-mononitrate, P = 0.021). Four patients responded to propranolol, three to isosorbide-5-mononitrate, and eight to both drugs; three did not show any change. Duplex Doppler sonography may be of use in the selection of the right pharmacologic treatment for the individual patient for the prevention of a bleeding esophageal varix.
Tincani
E
E
Clinica Medica III, University of Modena, Italy.
Cioni
G
G
Cristani
A
A
D'Alimonte
P
P
Vignoli
A
A
Abbati
G
G
Ventura
P
P
Romagnoli
R
R
Ventura
E
E
D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D016903:Drug Monitoring; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D007548:Isosorbide Dinitrate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D013152:Splanchnic Circulation / Q000187:drug effects; D014463:Ultrasonography
D003692:Delayed-Action Preparations; D011433:Propranolol; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate