Duplex-Doppler evaluation of the effects of propranolol and isosorbide-5-mononitrate on portal flow and splanchnic arterial circulation in cirrhosis

Alimentary Pharmacology & Therapeutics
F PiscagliaL Bolondi

Abstract

A decrease in portal flow is an important pharmacological effect of drugs used for the prophylaxis of variceal bleeding. To assess the acute and chronic effects of propranolol, and the effect of the acute addition of isosorbide-5-mononitrate, on splanchnic circulation. Measurements of portal blood flow volume (PBFV) and of Doppler ultrasound pulsatility index of the superior mesenteric, femoral and interlobar renal arteries were performed in 10 cirrhotic patients with varices at baseline, 90 min after propranolol or placebo, after 30 days of chronic propranolol treatment and 45 min after the addition of isosorbide-5-mononitrate. The mean PBFV was significantly lower at all times than at baseline, with the greatest mean percentage decrease achieved after the addition of isosorbide-5-mononitrate (> or = 20% in all patients). Acute changes, however, did not predict the chronic effects in many patients. Isosorbide-5-mononitrate significantly increased the mesenteric and femoral pulsatility indices, whereas no significant change was observed in the kidney. Propranolol significantly decreases PBFV, but chronic effects cannot be reliably predicted by the acute change. All patients achieved a decrease in PBFV of > or = 20% after the ac...Continue Reading

References

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Citations

Aug 26, 1999·Ultrasound in Medicine & Biology·F PiscagliaL Bolondi
Dec 20, 2007·Journal of Clinical Ultrasound : JCU·Naile Bolca TopalUgur Topal
Apr 7, 2021·The Cochrane Database of Systematic Reviews·Davide RoccarinaKurinchi Selvan Gurusamy

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