Titre du document / Document title

Effects of long-term propranolol and octreotide on postprandial hemodynamics in cirrhosis: A randomized, controlled trial

Auteur(s) / Author(s)

VOROBIOFF Julio D. ⁽¹⁾ ; GAMEN Marcelo ⁽¹⁾ ; KRAVETZ David ⁽²⁾ ; PICABEA Eduardo ⁽¹⁾ ; VILLAVICENCIO Roberto ⁽¹⁾ ; BORDATO Juan ⁽¹⁾ ; RUF Andres ⁽¹⁾ ; BESSONE Fernando ⁽¹⁾ ; ROMERO Gustavo ⁽²⁾ ; PALAZZI Jorge ⁽³⁾ ; NICORA Alicia ⁽³⁾ ; PASSAMONTI Maria ⁽¹⁾ ; TANNO Hugo ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Liver Unit and Hepatic Hemodynamic Laboratory, Fundación Dr. J. R. Villavicencio & Sanatorio Parque, Rosario, ARGENTINE
⁽²⁾ Hospital Bonorino Udaondo, Buenos Aires, ARGENTINE
⁽³⁾ Instituto de Estudios Bioquímicos, Rosario, ARGENTINE

Résumé / Abstract

Background & Aims: Postprandial increases in portal pressure may influence esophageal variceal rupture. The effects of chronic propranolol and octreotide (100 and 200 μg subcutaneously in a single dose) on postprandial hemodynamics were evaluated. Methods: First study: 36 cirrhotic patients were studied at baseline and 30 and 60 minutes after a standard meal and then treated with propranolol (139 ± 9 mg/d during 39 ± 2 days). Second study: After baseline measurements, patients were randomized into 3 groups: (1) placebo, (2) octreotide (100 μg), or (3) octreotide (200 μg) (n = 12 for each group). Thirty minutes postinjection a new baseline was established and measurements were repeated 30 and 60 minutes after the meal. Results: First study: Baseline portal pressure was 18.1 ± 1.2 mm Hg, 30 and 60 minutes after the meal it was 21.5 ± 0.8 mm Hg and 20.5 ± 0.8 mm Hg, respectively (both P < 0.01 vs. baseline). Cardiac index (Cl) was 4.5 ± 0.2, 4.8 ± 0.2, and 4.9 ± 0.2 L min^-1 m^-2, respectively (both P < 0.05 vs. baseline). Peripheral vascular resistance was 1012 ± 56, 902 ± 51 (P = NS), and 884 ± 49 dynes sec cm^-5 (P < 0.05 vs. baseline), respectively. Second study: Propranolol and placebo did not blunt postprandial increase in portal pressure. Octreotide (100 μg) partially ameliorated postprandial increase in portal pressure. Octreotide (200 μg) significantly enhanced the portal hypotensive effect of propranolol and blunted the postprandial increase in portal pressure. Conclusions: Octreotide blunts postprandial increase in portal pressure not prevented by long-term propranolol administration.

Revue / Journal Title

Gastroenterology   ISSN 0016-5085   CODEN GASTAB 

Source / Source

2002, vol. 122, n^o4, pp. 916-922 (39 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1943) (Revue)

Mots-clés anglais / English Keywords

Vascular disease ; Cardiovascular disease ; Portal circulation disease ; Hepatic disease ; Digestive diseases ; America ; South America ; Analog ; Argentina ; Human ; Randomization ; Clinical trial ; Long lasting ; Octreotide ; Somatostatin ; Beta blocking agent ; Propranolol ; Biological activity ; Postprandial ; Portal hypertension ; Complication ; Liver ; Cirrhosis ;

Mots-clés français / French Keywords

Vaisseau sanguin pathologie ; Appareil circulatoire pathologie ; Circulation portale pathologie ; Foie pathologie ; Appareil digestif pathologie ; Amérique ; Amérique du Sud ; Analogue ; Argentine ; Homme ; Randomisation ; Essai clinique ; Longue durée ; Octréotide ; Somatostatine ; Bloquant β-adrénergique ; Propranolol ; Activité biologique ; Postprandial ; Hypertension portale ; Complication ; Foie ; Cirrhose ;

Mots-clés espagnols / Spanish Keywords

Vaso sanguíneo patología ; Aparato circulatorio patología ; Circulación portal patología ; Hígado patología ; Aparato digestivo patología ; America ; America del sur ; Análogo ; Argentina ; Hombre ; Aleatorización ; Ensayo clínico ; Larga duración ; Octreotida ; Somatostatina ; Bloqueador β-adrenérgico ; Propranolol ; Actividad biológica ; Postprandial ; Hipertensión portal ; Complicación ; Hígado ; Cirrosis ;

Localisation / Location

INIST-CNRS, Cote INIST : 2090, 35400010792910.0090