title: Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients.
abstract: OBJECTIVE
  To evaluate the effect of beta-blockade on angiotensins in the splanchnic and peripheral circulation of cirrhotic patients and also to compare hemodynamic parameters during liver transplantation according to propranolol pre-treatment or not.
  
  
  METHODS
  Patients were allocated into two groups: outpatients with advanced liver disease(LD) and during liver transplantation(LT). Both groups were subdivided according to treatment with propranolol or not. Plasma was collected through peripheral venipuncture to determine plasma renin activity(PRA), Angiotensin(Ang) I, Ang II, and Ang-(1-7) levels by radioimmunoassay in LD group. During liver transplantation, hemodynamic parameters were determined and blood samples were obtained from the portal vein to measure renin angiotensin system(RAS) components.
  
  
  RESULTS
  PRA, Ang I, Ang II and Ang-(1-7) were significantly lower in the portal vein and periphery in all subgroups treated with propranolol as compared to non-treated. The relationships between Ang-(1-7) and Ang I levels and between Ang II and Ang I were significantly increased in LD group receiving propranolol. The ratio between Ang-(1-7) and Ang II remained unchanged in splanchnic and peripheral circulation in patients under beta-blockade, whereas the relationship between Ang II and Ang I was significantly increased in splanchnic circulation of LT patients treated with propranolol. During liver transplantation, cardiac output and index as well systemic vascular resistance and index were reduced in propranolol-treated subgroup.
  
  
  CONCLUSIONS
  In LD group, propranolol treatment reduced RAS mediators, but did not change the ratio between Ang-(1-7) and Ang II in splanchnic and peripheral circulation. Furthermore, the modification of hemodynamic parameters in propranolol treated patients was not associated with changes in the angiotensin ratio.
authors.affiliation: Laboratório de Hipertensão, Departamento de Fisiologia e Biofísica, ICB-UFMG, Av. Antonio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil.
authors.forename: Walkíria Wingester
authors.initials: WW
authors.lastname: Vilas-Boas
authors.forename: Antônio
authors.initials: A
authors.lastname: Ribeiro-Oliveira
authors.forename: Renata da Cunha
authors.initials: Rda C
authors.lastname: Ribeiro
authors.forename: Renata Lúcia Pereira
authors.initials: RL
authors.lastname: Vieira
authors.forename: Jerusa
authors.initials: J
authors.lastname: Almeida
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Nadu
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões e Silva
authors.forename: Robson Augusto Souza
authors.initials: RA
authors.lastname: Santos
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000803:Angiotensin I / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D000809:Angiotensins / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011169:Portal Vein; D011433:Propranolol / Q000627:therapeutic use*; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013152:Splanchnic Circulation
chemical_list: D000319:Adrenergic beta-Antagonists; D000809:Angiotensins; D010446:Peptide Fragments; D000804:Angiotensin II; D000803:Angiotensin I; D011433:Propranolol; D012083:Renin; C118790:angiotensin I (1-7)