Effect of propranolol on metabolic activity of the liver in patients with alcoholic cirrhosis

Vinel, Jean Pierre; Caucanas, J. P.; Calès, Paul; Suduca, J. M.; Voigt, Jean‐Jacques; Pascal, Jean‐Pierre

doi:10.1016/s0168-8278(88)80481-1

Cited by 25 publications

(5 citation statements)

References 22 publications

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“…These findings confirm previous studies (8)(9)(10)(11)(12) showing that plasma volume depletion decreases portal pressure in portal hypertension, which reinforces the idea that an increased plasma volume contributes to maintainand probably aggravatesportal hypertension (2,6,7,18). The mean reduction in HVPG caused by spironolactone (13%) compares well with that produced by propranolol, which usually ranges between 10% and 18% (19)(20)(21)(22)(23). However, contrary to propranolol (24), spironolactone did not cause significant changes in hepatic blood flow and liver function, as evaluated by measurements of the hepatic and intrinsic clearance of ICG.…”

Section: Discussionsupporting

confidence: 90%

Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis†

et al. 1994

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The aim of this study was to investigate the hemodynamic effects of spironolactone associated with a low-sodium diet (n = 14) or a low-sodium diet alone (n = 9) in patients with compensated cirrhosis and portal hypertension. Spironolactone significantly reduced the plasma volume. This effect was associated with a significant reduction in the hepatic venous pressure gradient, from 17.6 +/- 3.6 mm Hg to 15.3 +/- 3.5 mm Hg (-13% +/- 13%; p < 0.01). Azygos blood flow (-20% +/- 20%), cardiac output (-16.2% +/- 10.5%) and mean arterial pressure (-9% +/- 9%) also decreased significantly. However, there were no significant changes in hepatic blood flow. Patients receiving low-sodium diet alone experienced a mild but significant reduction in hepatic venous pressure gradient (-6.3% +/- 6%) and in mean arterial pressure (-4% +/- 5%). There were no significant changes in cardiac output and in hepatic or azygos blood flows. This study indicates that low-sodium diet plus administration of spironolactone reduces portal pressure and azygos blood flow in patients with compensated cirrhosis. Low-sodium diet alone only produces mild effects that are likely to be clinically irrelevant.

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Section: Discussionsupporting

confidence: 90%

Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis†

et al. 1994

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“…A similar result was reported with the subcutaneous transposition of the rat spleen 11. Propranolol and vasopressin also might be effective because they reduce portal hypertension in cirrhotic patients who exhibit a hyperdynamic state as well as PCS 31–34…”

Section: Discussionsupporting

confidence: 77%

“…11 Propranolol and vasopressin also might be effective because they reduce portal hypertension in cirrhotic patients who exhibit a hyperdynamic state as well as PCS. [31][32][33][34] Figure 6. Transmission electron microscopical photograph of the sinusoid after extended hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

Effect of Portocaval Shunt on Residual Extreme Small Liver after Extended Hepatectomy in Porcine

et al. 2006

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“…It has previously been demonstrated that ICG clearance decreases after a single dose of propranolol (22,23). In the present study an insignificant decrease was observed for the propranolol group, whereas an insignificant increase was observed for the control group.…”

Section: Discussionsupporting

confidence: 46%

Long-Term Effects of Oral Propranolol on Splanchnic and Systemic Haemodynamics in Patients with Cirrhosis and Oesophageal Varices

Bendtsen

Henriksen

Sørensen

1991

Scandinavian Journal of Gastroenterology

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Splanchnic and systemic haemodynamics were measured in 24 patients with cirrhosis and oesophageal varices and no previous bleeding. The patients were randomized either to long-term treatment with propranolol (14 patients) or no active treatment (controls, 10 patients). Catheterization was performed again 1 year after randomization. After 1 year of treatment the hepatic venous pressure gradient had decreased in both the propranolol and control group (-16% versus -24% (NS), respectively). Hepatic blood flow decreased substantially in both groups but significantly more in the propranolol group (-39% versus -17% (p less than 0.05), respectively). Azygos blood flow was significantly reduced after 1 year in the propranolol group (-47%, n = 5 (p less than 0.05)), and no obvious effect was observed in the control group (-2%, n = 4). The cardiac index decreased significantly in the propranolol group but not in the control group (-20% versus -1% (p less than 0.05), respectively). Our results demonstrate that the splanchnic hyperdynamic condition observed in cirrhosis is in some of the patients partly reversible without pharmacologic treatment. No additional effect of propranolol was observed on portal pressure after 1 year of treatment with propranolol, whereas a decrease in azygos blood flow was observed only in the propranolol group. The beneficial effect of propranolol on the risk of bleeding from oesophageal varices may, therefore, mostly be due to a selective decrease in collateral blood flow and thereby variceal blood flow.

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Effect of propranolol on metabolic activity of the liver in patients with alcoholic cirrhosis

Cited by 25 publications

References 22 publications

Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis†

Effects of low-sodium diet and spironolactone on portal pressure in patients with compensated cirrhosis†

Effect of Portocaval Shunt on Residual Extreme Small Liver after Extended Hepatectomy in Porcine

Long-Term Effects of Oral Propranolol on Splanchnic and Systemic Haemodynamics in Patients with Cirrhosis and Oesophageal Varices

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