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Postprandial vascular response in patients with cirrhosis

Short-term effects of propranolol administration

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Abstract

Systemic and portal hemodynamic parameters were evaluated in eight cirrhotic patients in basal conditions and after food intake and placebo. Following seven days of oral propranolol administration, hemodynamic parameters were reevaluated in the fasting and postprandial states under similar conditions. Cardiac output and portal blood flow were measured by Doppler technique. Intraobserver variability of repeated measurements was less than 10%. Food intake caused a significant increase of portal blood flow (+28%,P<0.05). No significant changes were observed in the other hemodynamic parameters studied. Propranolol at doses achieving effective beta blockade (84±14 mg/day) (mean±sd) reduced portal blood flow (−24%,P<0.05). Food intake caused a significant increase in portal blood flow (+35%,P<0.05) in propranolol treated patients. However, in absolute values, postprandial portal blood flow during propranolol treatment was significantly lower (986±402 ml/min) than that obtained after the initial food intake (1214±537 ml/min,P<0.05). Placebo administration had no significant hemodynamic effects in either group. This study demonstrates that chronic propranolol administration could protect from portal hemodynamic changes following food intake. Doppler technique is a reliable technique to evaluate changes on portal and systemic hemodynamic parameters during a short period of time in patients with cirrhosis.

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Authors and Affiliations

  1. From the Liver Section, Hospital Nacional de Gastroenterologia, Dr. Bonorino Udaondo, Argentina

    Daniel Alvarez MD, Carlos Miguez MD, Ana Podesta MD, Ruben Terg MD, Alvaro Sanchez Malo MD, Juan Carlos Bandi MD, Susana Sanchez PhD &  Ricardo Mastai MD

  2. Liver Section, Instituto de Gastroenterologia, Dr. Jorge Perez Companc, Potosi 4240, 1199, Buenos Aires, Argentina

    Daniel Alvarez MD, Carlos Miguez MD, Ana Podesta MD, Ruben Terg MD, Alvaro Sanchez Malo MD, Juan Carlos Bandi MD, Susana Sanchez PhD &  Ricardo Mastai MD

Authors
  1. Daniel Alvarez MD
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  2. Carlos Miguez MD
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  3. Ana Podesta MD
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  4. Ruben Terg MD
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  5. Alvaro Sanchez Malo MD
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  6. Juan Carlos Bandi MD
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  7. Susana Sanchez PhD
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  8. Ricardo Mastai MD
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Alvarez, D., Miguez, C., Podesta, A. et al. Postprandial vascular response in patients with cirrhosis. Digest Dis Sci 39, 1288–1293 (1994). https://doi.org/10.1007/BF02093795

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  • DOI: https://doi.org/10.1007/BF02093795

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