title: Effects of carvedilol and propranolol on circulatory regulation and oxygenation in cirrhosis: a randomised study.
abstract: OBJECTIVE
  Newer studies suggest that carvedilol, a beta-blocker with a moderate anti-alpha-1 activity, is superior to propranolol in reducing the portal pressure and risk of variceal bleeding. The effect on arterial blood pressure is a matter of concern especially in decompensated patients.
  
  
  OBJECTIVE
  to assess potential differential effects of beta-blockers and beta-blockers with moderate anti-alpha-1 activity on selected haemodynamic, humoral, and respiratory characteristics in cirrhosis.
  
  
  METHODS
  Patients with cirrhosis and portal hypertension were randomised to receive carvedilol (n=16) or propranolol (n=13). Cardiac, systemic and splanchnic parameters along with oxygen saturation and plasma renin were measured at inclusion and after 3 months.
  
  
  RESULTS
  Arterial blood pressure, heart rate, and cardiac output decreased equally, central circulation time and systemic vascular resistance increased significantly but similarly. Central blood volume, plasma volume and arterial compliance were unaltered. The QTc interval and renin levels decreased in the carvedilol group, however not significantly different from the propranolol group. Arterial oxygen saturation and alveolar arterial oxygen gradient remained constant in both groups. Hepatic venous pressure gradient decreased equally in the carvedilol and propranolol groups (-17% and -20%, non significant).
  
  
  CONCLUSIONS
  Systemic haemodynamics and pulmonary effects of carvedilol and propranolol are modest and this study could not demonstrate any significant difference between the two treatments.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Center of Functional and Diagnostic Imaging and Research, Copenhagen University, Hvidovre, Denmark; Gastro Unit, Medical Division, Hvidovre University Hospital, Faculty of Health Sciences, Copenhagen University, Hvidovre, Denmark. Electronic address: lise@hobolth.dk.
authors.forename: Lise
authors.initials: L
authors.lastname: Hobolth
authors.affiliation: Gastro Unit, Medical Division, Hvidovre University Hospital, Faculty of Health Sciences, Copenhagen University, Hvidovre, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
authors.affiliation: Gastro Unit, Medical Division, Hvidovre University Hospital, Faculty of Health Sciences, Copenhagen University, Hvidovre, Denmark.
authors.forename: Erik F
authors.initials: EF
authors.lastname: Hansen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Center of Functional and Diagnostic Imaging and Research, Copenhagen University, Hvidovre, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Møller
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001158:Arteries; D001794:Blood Pressure; D001810:Blood Volume; D002227:Carbazoles / Q000627:therapeutic use*; D002302:Cardiac Output; D000077261:Carvedilol; D003187:Compliance; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010953:Plasma Volume; D017082:Portal Pressure; D011412:Propanolamines / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use*; D012083:Renin / Q000097:blood; D016896:Treatment Outcome; D014655:Vascular Resistance
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D011433:Propranolol; D012083:Renin
keywords: Carvedilol; Haemodynamics; Propranolol; Randomised trial