The 35-year odyssey of beta blockers in cirrhosis: any gender difference in sight?

Burza, Maria Antonella; Marschall, Hanns‐Ulrich; Napoleone, Laura; Molinaro, Antonio

doi:10.1016/j.phrs.2017.01.015

Cited by 6 publications

(3 citation statements)

References 75 publications

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“…Only 37% of the cohort with esophageal varices were taking β -blockers. Th e increasing controversy about the use of β -blockers in patients with advanced cirrhosis and complications ( 30,31 ) and the design of this study, which did not require a standardize…”

Section: Study Limitationsmentioning

confidence: 99%

Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study

Basili

Raparelli

Napoleone

et al. 2018

American Journal of Gastroenterology

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Section: Study Limitationsmentioning

confidence: 99%

Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study

Basili

Raparelli

Napoleone

et al. 2018

American Journal of Gastroenterology

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“…The inclusion criteria were as follows: a) patients meeting the diagnostic criteria for UGIB in liver cirrhosis [ 11 ], b) those with typical symptoms such as peripheral circulatory failure, melena, and haematemesis, c) those with a history of hepatitis B, d) those with bleeding for the first time, and e) those with complete clinical data.…”

Section: Methodsmentioning

confidence: 99%

Effects of gastrointestinal endoscopy at different time points on diagnosis and treatment of upper gastrointestinal bleeding in patients with liver cirrhosis.

Sun,

Zhou,

Shu

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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Introduction Liver cirrhosis is a common diffuse and persistent liver disease in the gastroenterology department. Aim To assess the effects of gastrointestinal endoscopy at different time points on the diagnosis and treatment of upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis. Material and methods The clinical data of 102 liver cirrhosis patients with UGIB admitted from July 2020 to May 2022 were retrospectively analysed. According to the timing of the first gastroscopy after hospitalization, the patients were divided into 4 groups: Group A (n = 25, gastroscopy performed within 12 h of the first bleeding), Group B (n = 29, gastroscopy performed within 12–48 h of the first bleeding), Group C (n = 25, elective gastroscopy performed > 48 h after the first bleeding), and Group D (n = 23, emergency gastroscopy was conducted due to active bleeding manifestations after failure of medication). Results The success rate of haemostasis in Group A was higher than in Groups B–D (p < 0.05). The early rebleeding rates of the 4 groups were similar (p > 0.05). After treatment, the levels of serum malondialdehyde and lipid hydrogen peroxide declined but the levels of glutathione peroxidase and superoxide dismutase rose in all groups compared to those immediately after hospitalization (p < 0.05), and these indicators were improved more significantly in Group A (p < 0.05). Conclusions Gastroscopy performed within 12 h of the first bleeding is more conducive to improving the haemostatic effect and thus shortening the length of hospital stay.

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“…Last but not least, the reproducibility of the HVPG determination, especially in less experienced centers, should also be taken into account when interpreting results of NSBBs on hemodynamics. Sex and etiology appear to be of minor importance for the effect of NSBB in liver cirrhosis ( 89 ).…”

Section: Non Selective ß-Ar Blockers and Their Influence On Pathomech...mentioning

confidence: 99%

Beta-blockers in patients with liver cirrhosis: Pragmatism or perfection?

et al. 2023

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With increasing decompensation, hyperdynamic circulatory disturbance occurs in liver cirrhosis despite activation of vasoconstrictors. Here, the concept of a therapy with non-selective beta-blockers was established decades ago. They lower elevated portal pressure, protect against variceal hemorrhage, and may also have pleiotropic immunomodulatory effects. Recently, the beneficial effect of carvedilol, which blocks alpha and beta receptors, has been highlighted. Carvedilol leads to “biased-signaling” via recruitment of beta-arrestin. This effect and its consequences have not been sufficiently investigated in patients with liver cirrhosis. Also, a number of questions remain open regarding the expression of beta-receptors and its intracellular signaling and the respective consequences in the intra- and extrahepatic tissue compartments. Despite the undisputed role of non-selective beta-blockers in the treatment of liver cirrhosis, we still can improve the knowledge as to when and how beta-blockers should be used in which patients.

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The 35-year odyssey of beta blockers in cirrhosis: any gender difference in sight?

Cited by 6 publications

References 75 publications

Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study

Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study

Effects of gastrointestinal endoscopy at different time points on diagnosis and treatment of upper gastrointestinal bleeding in patients with liver cirrhosis.

Beta-blockers in patients with liver cirrhosis: Pragmatism or perfection?

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