Document Detail


Comparison of portal vein velocity and the hepatic venous pressure gradient in assessing the acute portal hemodynamic response to propranolol in patients with cirrhosis.
MedLine Citation:
PMID:  11051366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this prospective study was to compare noninvasive Doppler sonography and invasive measurement of the hepatic venous pressure gradient (HVPG) to determine the acute portal hemodynamic response to propranolol in patients with liver cirrhosis. METHODS: In a blinded study design, portal vein velocity (PVV) and HVPG were simultaneously assessed in 11 cirrhotic patients for 4 h after oral ingestion of 40 mg propranolol. RESULTS: Both HVPG (17.2% +/- 4.3%, p < 0.0001) and PVV (15.6% +/- 2.1%, p < 0.0002) showed a highly significant reduction during the study period versus baseline. Based on HVPG measurements, four patients (36%) were classified as nonresponders. These patients had a significantly lower PVV reduction compared to the responders (responders: 18.8% +/- 2.0% vs nonresponders: 10.0% +/- 2.1%, p < 0.05). Nonresponders were identified by Doppler sonography with a sensitivity of 1.0, specificity of 0.86, and positive predictive value of 0.9 when a threshold of 20% PVV reduction 120 min after drug intake was applied. CONCLUSIONS: Doppler sonography is a useful tool for assessment of the acute portal hemodynamic effect of propranolol. To distinguish portal hemodynamic nonresponders from responders to propranolol, PVV measurements should be carried out 2 h after drug administration, and PVV reduction should be not <20% in propranolol responders.
Authors:
M Schepke; P Raab; A Hoppe; P Schiedermaier; K A Brensing; T Sauerbruch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  95     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2905-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine I, University of Bonn, Germany.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Blood Flow Velocity / drug effects,  physiology
Female
Hemodynamics / drug effects*,  physiology
Hepatic Veins / drug effects*,  physiopathology,  ultrasonography
Humans
Liver Cirrhosis / drug therapy*,  physiopathology,  ultrasonography
Male
Middle Aged
Portal Pressure / drug effects*,  physiology
Portal System / drug effects*,  physiopathology,  ultrasonography
Portal Vein / drug effects*,  physiopathology,  ultrasonography
Propranolol / administration & dosage*,  adverse effects
Sensitivity and Specificity
Treatment Outcome
Ultrasonography, Doppler / drug effects
Chemical
Reg. No./Substance:
525-66-6/Propranolol
Comments/Corrections
Comment In:
Am J Gastroenterol. 2001 Jun;96(6):1947   [PMID:  11419865 ]

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