Propranolol reduces variceal pressure and wall tension in schistosomiasis presinusoidal portal hypertension.
OBJECTIVE
Although prophylaxis with beta-blockers has been shown to decrease variceal pressure and wall tension in cirrhotic patients, this has not been demonstrated in non-cirrhotic portal hypertension caused by Schistosoma mansoni infection.


METHODS
Thirteen patients without history of previous gastrointestinal bleeding were included. All of them had high-risk esophageal varices at endoscopy. An endoscopic gauge and a high-frequency endoscopic ultrasonography miniprobe were used to assess transmural variceal pressure and wall tension before and after achieving beta-blockade with propranolol.


RESULTS
Baseline variceal pressure decreased from 13.3 +/- 3.5 to 8.2 +/- 2.0 mmHg (P < 0.0001) and wall tension from 500.2 +/- 279.8 to 274.0 +/- 108.3 mg.mm(-1). The overall effect of propranolol on decreasing variceal pressure and wall tension expressed in percentage change in relation to baseline values was 35.7 +/- 18.4% and 35.9 +/- 26.7%, respectively (P = 0.9993).


CONCLUSIONS
Propranolol significantly reduced variceal pressure and wall tension in schistosomiasis.
Farias
Alberto Queiroz
AQ
Department of Gastroenterology, University of São Paulo School of Medicine, Brazil. albertofarias@terra.com.br
Kassab
Fabio
F
da Rocha
Evandra Cristina Vieira
EC
Dos Santos Bomfim
Valdinélia
V
Vezozzo
Denise Cerqueira Paranaguá
DC
Bittencourt
Paulo Lisboa
PL
Carrilho
Flair José
FJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000818:Animals; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000469:parasitology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011433:Propranolol / Q000627:therapeutic use*; D012555:Schistosomiasis mansoni / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014690:Venous Pressure / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D011433:Propranolol