Document Detail


Acute propranolol administration effectively decreases portal pressure in patients with TIPS dysfunction. Transjugular intrahepatic portosystemic shunt.
MedLine Citation:
PMID:  12477774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Up to 60% of patients treated with transjugular intrahepatic portosystemic shunt (TIPS) require angioplasty or restenting during the first year of follow up because of TIPS dysfunction (stenosis of the intrahepatic shunt increasing the portal pressure gradient above the 12 mm Hg threshold). We hypothesised that in patients with TIPS stenosis, propranolol administration, by decreasing portal inflow, would markedly decrease portal pressure.
PATIENTS AND METHODS: Eighteen patients with TIPS dysfunction were investigated by measuring portal pressure gradient before and after acute propranolol administration (0.2 mg/kg intravenously; n=18).
RESULTS: Propranolol markedly reduced the portal pressure gradient (from 16.6 (3.5) to 11.9 (4.8) mm Hg; p<0.0001), cardiac index (-26 (7)%), and heart rate (-18 (7)%) (p<0.0001). Portal pressure gradient decreased to less than 12 mm Hg in nine patients, more frequently in those with moderate dysfunction (portal pressure gradient 16 mm Hg) than in patients with severe dysfunction (portal pressure gradient >16 mm Hg) (8/10 v 1/8; p=0.015).
CONCLUSIONS: Propranolol therapy may delay the increase in portal pressure and reduce the need for reintervention in patients with TIPS dysfunction.
Authors:
L Bellis; E Moitinho; J G Abraldes; M Graupera; J C García-Pagán; J Rodés; J Bosch
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  52     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2002-12-12     Completed Date:  2003-02-20     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  130-3     Citation Subset:  AIM; IM    
Affiliation:
Hepatic Hemodynamic Laboratory, Liver Unit, IMD, Hospital Clínic, Institut d'Investigacions Biomédiques August Pi I Sunyer, University of Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / therapeutic use*
Cardiac Output / drug effects
Heart Rate / drug effects
Humans
Hypertension, Portal / drug therapy,  surgery*
Middle Aged
Portal Pressure / drug effects
Portasystemic Shunt, Transjugular Intrahepatic*
Propranolol / therapeutic use*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 525-66-6/Propranolol
Comments/Corrections

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