Differing actions of the acute administration of propranolol and isosorbide-5-mononitrate on the portal circulation.
Aliment Pharmacol Ther
; 10(5): 795-800, 1996 Oct.
Article
en En
| MEDLINE
| ID: mdl-8899089
ABSTRACT
BACKGROUND:
The aim of this study was to clarify the actions of propranolol and isosorbide-5-mononitrate upon the portal circulation.METHODS:
Portal haemodynamics were assessed in 16 patients with transjugular intrahepatic portosystemic stent shunts. A reverse thermodilution catheter was positioned in the portal vein, and portal vein pressure and portal vein flow were measured directly. The effects of propranolol 80 mg and isosorbide-5-mononitrate 20 mg over 1 h were determined independently.RESULTS:
This demonstrated that propranolol reduced both portal pressure gradient (7.7 +/- 2.3 to 5.5 +/- 2.1 mmHg, P < 0.01) and portal vein flow (925 +/- 123 to 597 +/- 99 mL/min, P = 0.01) significantly, implying a reduction in splanchnic inflow as its main effect. In contrast, isosorbide-5-mononitrate tended to increase portal vein flow (814 +/- 186 to 911 +/- 211 mL/min; P = 0.06) whilst reducing portal pressure significantly (108 +/- 12 to 92 +/- 10 mmHg P = 0.014). This suggests a fall in intrahepatic resistance and provides no evidence for baroreceptor-mediated reflex splanchnic vasoconstriction.CONCLUSIONS:
These drugs act upon different variables contributing to portal hypertension and so they may have a powerful synergistic effect in combination. Direct measurement of portal vein flow is a valuable method for assessing the pharmacological modulation of portal venous inflow.
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Banco de datos:
MEDLINE
Asunto principal:
Vena Porta
/
Propranolol
/
Vasodilatadores
/
Dinitrato de Isosorbide
/
Circulación Hepática
Límite:
Female
/
Humans
/
Male
Idioma:
En
Año:
1996
Tipo del documento:
Article