| Acute and chronic hemodynamic changes after propranolol in patients with cirrhosis under primary and secondary prophylaxis of variceal bleeding: a pilot study. | |
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MedLine Citation:
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PMID: 20150817 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIM: Prophylactic treatment of variceal bleeding in cirrhotic patients with beta-blockers is effective in only some patients. Our aim was to determine whether the response of the hepatic venous pressure gradient (HVPG) to the intravenous administration of propranolol predicts the response after chronic oral propranolol treatment. PATIENTS AND METHODS: We included prospectively cirrhotic patients with esophageal varices under primary prophylaxis (PP) and secondary prophylaxis (SP). The HVPG was measured at baseline and after a propranolol bolus (0.15 mg/kg intravenous). A patient was considered a good-responder if HVPG decreased to 12 mmHg or 20% from baseline. Patients then received oral propranolol (heart rate titrated). Poor-responders under SP were also included in a variceal band ligation program. After at least 3 months, a second hemodynamic study was conducted. RESULTS: Fifty-six patients were included (36 SP and 20 PP). Response rate was similar (32.1 and 41.9%, P=0.7) and the Pearson's correlation coefficient was 0.61 (P=0.001). In 81.4% patients, the first study predicted the response status of the second. Six patients rebled on follow-up between the studies, all of them were poor responders to intravenous propranolol. CONCLUSION: A single hemodynamic study using intravenous propranolol seems to predict chronic response to propranolol. |
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Authors:
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Enrique de-Madaria; José María Palazón; Flavia Tamara Hernández; José Sánchez-Paya; Pedro Zapater; Javier Irurzun; Francisco de España; Sonia Pascual; José Such; Laura Sempere; Fernando Carnicer; Antonio García-Herola; Jaime Valverde; Miguel Pérez-Mateo |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 22 ISSN: 1473-5687 ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-15 Completed Date: 2010-07-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 507-12 Citation Subset: IM |
Affiliation:
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Unidad hepática, Hospital General Universitario de Alicante, Alicante, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adrenergic beta-Antagonists / administration & dosage* Esophageal and Gastric Varices / drug therapy*, etiology*, prevention & control Female Follow-Up Studies Heart Rate / drug effects Humans Injections, Intravenous Liver Cirrhosis / complications* Male Middle Aged Pilot Projects Predictive Value of Tests Propranolol / administration & dosage* Prospective Studies Treatment Outcome Venous Pressure / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 525-66-6/Propranolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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