title: Measurement of variceal pressure with a computerized endoscopic manometry: validation and effect of propranolol therapy in cirrhotic patients.
abstract: OBJECTIVE
  Recently, we invented a computerized endoscopic balloon manometry (CEBM) to measure variceal pressure (VP) in cirrhotic patient. The purpose of this study was to evaluate the reliability and feasibility of this method, and whether this technique provided further information to pharmacological therapy.
  
  
  METHODS
  VP measurements were performed in 83 cirrhotic patients and compared with HVPG as well as endoscopic bleeding risk parameters. Furthermore, VP was assessed before and during propranolol therapy in 30 patients without previous bleeding.
  
  
  RESULTS
  VP measurements were successful in 96% (83/86) of all patients. Of the 83 patients, the VP correlated closely with the HVPG (P<0.001). The presence of red colour signs and the size of varices were strongly associated with VP. Patients with previous bleeding had higher VP than those who had not yet experienced bleeding. In univariate analysis, the level of VP, the size of varices, and red color signs predicted a higher risk of bleeding. The multiple logistic regression model revealed that VP was the major risk factor for bleeding. In 30 patients receiving propranolol, VP significantly decreased from 21.1 ± 3.5 mmHg before therapy to 18.1 ± 3.3 mmHg after 3 months and to 16.3 ± 4.0 mmHg after 6 months. Comparing the mean decrease in VP with that in hepatic venous pressure gradient (HVPG), the decrease in VP was more obvious than HVPG response to propranolol.
  
  
  CONCLUSIONS
  This study showed that CEBM is safe and practical to assess VP in cirrhotic patient. It has the potential to be used as a clinical method to assess the risk of variceal bleeding and the effects of pharmacological therapy.
  
  
  BACKGROUND
  Effect of vasoactive drugs on esophageal variceal hemodynamics in patients with portal hypertension. Chinese Clinical Trial Registry -TRC-08000252.
authors: Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
authors: De-Run
authors: DR
authors: Kong
authors: Chao
authors: C
authors: Zhang
authors: Lei
authors: L
authors: Zhang
authors: Jing-Guang
authors: JG
authors: Wang
authors: Zhuang
authors: Z
authors: Xiong
authors: Pan
authors: P
authors: Li
authors: Jian-Ming
authors: JM
authors: Xu
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D004932:Esophageal and Gastric Varices / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000295:instrumentation; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008365:Manometry / Q000295:instrumentation; D008875:Middle Aged; D011433:Propranolol / Q000008:administration & dosage*; D016896:Treatment Outcome; D014690:Venous Pressure
chemical_list: D000959:Antihypertensive Agents; D011433:Propranolol