Effect of Beta-adrenergic Blockade on Elevated Arterial Compliance and Low Systemic Vascular Resistance in Cirrhosis

Möller, Sören; Bendtsen, Flemming; Henriksen, Jens H.

doi:10.1080/003655201750163196

Cited by 10 publications

(3 citation statements)

References 31 publications

(33 reference statements)

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“…In parallel, systemic vascular resistance (SVR) and its index increased and cardiac output (CO) and its index decreased in non-compensated cirrhotic patients treated with propranolol. Similar hemodynamic changes in cirrhotic patients receiving propranolol have already been reported [17][18][19] and attributed to β-adrenergic blockade [20] . Since the relationship between Ang-(1-7) and Ang Ⅱ remained unchanged in splanchnic and peripheral circulation of our cirrhotic patients, we could hypothesize that propranolol was not able to interfere with the final functional RAS effect upon vascular tone.…”

Section: Applicationssupporting

confidence: 60%

Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients

Vilas-Boas

Ribeiro‐Oliveira²,

Ribeiro³

et al. 2008

WJG

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AIM:To evaluate the effect of β-blockade on angiotensins in the splanchnic and peripheral circulation of cirrhotic patients and also to compare hemodynamic parameters during liver transplantation according to propranolol pre-treatment or not. METHODS: Patients were al located into two groups: outpatients with advanced liver disease(LD) and during liver transplantation(LT). Both groups were subdivided according to treatment with propranolol or not. Plasma was collected through peripheral venipuncture to determine plasma renin activity(PRA), Angiotensin(Ang) Ⅰ, Ang Ⅱ, and Ang-(1-7) levels by radioimmunoassay in LD group. During liver transplantation, hemodynamic parameters were determined and blood samples were obtained from the portal vein to measure renin angiotensin system(RAS) components. RESULTS:PRA, Ang Ⅰ, Ang Ⅱ and Ang-(1-7) were significantly lower in the portal vein and periphery in all subgroups treated with propranolol as compared to non-treated. The relationships between Ang-(1-7) and Ang Ⅰ levels and between Ang Ⅱ and Ang Ⅰ were s igni f ic a nt ly inc re a s e d in LD gro up re c e i v i n g propranolol. The ratio between Ang-(1-7) and Ang Ⅱ remained unchanged in splanchnic and peripheral circulation in patients under β-blockade, whereas the relationship between Ang Ⅱ and Ang Ⅰ was significantly increased in splanchnic circulation of LT patients treated with propranolol. During liver transplantation, cardiac output and index as well systemic vascular resistance and index were reduced in propranolol-treated subgroup. CONCLUSION: In LD group, propranolol treatment reduced RAS mediators, but did not change the ratio between Ang-(1-7) and Ang Ⅱ in splanchnic and peripheral circulation. Furthermore, the modification of hemodynamic parameters in propranolol treated patients was not associated with changes in the angiotensin ratio. Vilas-Boas WW, Ribeiro-Oliveira Jr A, Cunha Ribeiro R, Vieira RLP, Almeida J, Nadu AP, Simões e Silva AC, Santos RAS. Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients.

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Section: Applicationssupporting

confidence: 60%

Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients

Vilas-Boas

Ribeiro‐Oliveira²,

Ribeiro³

et al. 2008

WJG

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“…However arterial compliance is in fact less than 1% of total vascular compliance. Though an increased arterial vascular compliance has been demonstrated in patients with cirrhosis and portal hypertension [25], the magnitude of this increase is less than 1.5-fold and is, therefore, unlikely to have an impact in total vascular compliance. The venous system accounts for as much as 80% of the total vascular volume [26,27].…”

Section: Discussionmentioning

confidence: 93%

“…Previous results in humans showed that propranolol does not modify central blood volume in patients with cirrhosis and portal hypertension [25]. This could be explained because propranolol also decreases cardiac output and increases venous and porto-collateral resistance [24].…”

Section: Study Limitationsmentioning

confidence: 96%

Effects of propranolol on venous compliance in conscious rats with pre-hepatic portal hypertension

García‐Pagán

Lionetti

Piera

et al. 2006

Journal of Hepatology

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Secondary Prophylaxis in Special Patient Populations

Reiberger

Moreau

Ripoll

et al. 2016

Portal Hypertension VI

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Effect of Beta-adrenergic Blockade on Elevated Arterial Compliance and Low Systemic Vascular Resistance in Cirrhosis

Abstract: Treatment with beta-blockers increases small vessel (arteriolar) vascular tone towards the normal level, but does not affect the elevated compliance of the larger arteries in patients with cirrhosis.

Cited by 10 publications

References 31 publications

Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients

Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients

Effects of propranolol on venous compliance in conscious rats with pre-hepatic portal hypertension

Secondary Prophylaxis in Special Patient Populations

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