Acute Administration of Carvedilol is More Effective than Propranolol Plus Isosorbide-5-Mononitrate in the Reduction of Portal Pressure in Patients with Viral Cirrhosis

[Guest guest]

Am J Gastroenterol. 2004 Oct;99(10):1953-8.

Acute Administration of Carvedilol is More Effective than Propranolol Plus

Isosorbide-5-Mononitrate in the Reduction of Portal Pressure in Patients

with Viral Cirrhosis.

Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD.

Division of Gastroenterology, Department of Medicine, Taipei Veterans

General Hospital, Taipei, Taiwan.

OBJECTIVE: Propranolol is known to decrease portal pressure in cirrhotic

patients with portal hypertension; however, a substantial number of patients

do not respond to propranolol administration. The addition of

isosorbide-5-mononitrate may enhance portal pressure reduction in patients

receiving propranolol. Carvedilol is a nonselective beta-blocker with

alpha(1)-adrenergic blocking activity. It has been shown to decrease portal

pressure in cirrhotic patients. Additionally, carvedilol has a greater

portal hypotensive effect than propranolol alone in patients with cirrhosis.

The current study is aimed at comparing the acute hemodynamic effects of

carvedilol with the effects of propranolol plus isosorbide-5-mononitrate in

patients with viral cirrhosis. METHODS: Patients with viral cirrhosis were

randomly assigned to receive an oral administration of carvedilol of 25 mg

(n = 11) or an oral administration of propranolol 40 mg plus

isosorbide-5-mononitrate 20 mg (n = 11). Hemodynamic values were measured at

basal and 90 min after drugs administration. RESULTS: Both carvedilol and

propranolol plus isosorbide-5-mononitrate significantly decreased cardiac

index, heart rate, and HVPG. The magnitude of changes in HVPG observed

between the basal and after drugs administration was greater in patients

receiving carvedilol than in those receiving propranolol plus

isosorbide-5-mononitrate (-18.6 +/- 3.6%vs-10.1 +/- 3.6%, p < 0.05). Hepatic

blood flow increased following carvedilol administration but remained

unchanged in patients receiving propranolol plus isosorbide-5-mononitrate.

The magnitude of decrease in mean arterial pressure (MAP) did not differ

between the two groups of patients. CONCLUSION: In our patients with viral

cirrhosis, carvedilol is more effective than propranolol plus

isosorbide-5-mononitrate in the reduction of HVPG. Carvedilol administration

causes an increase in hepatic blood flow, but its systemic effects were

similar to those of propranolol plus isosorbide-5-mononitrate.

PMID: 15447755 [PubMed - in process

[Guest guest]

Am J Gastroenterol. 2004 Oct;99(10):1953-8.

Acute Administration of Carvedilol is More Effective than Propranolol Plus

Isosorbide-5-Mononitrate in the Reduction of Portal Pressure in Patients

with Viral Cirrhosis.

Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD.

Division of Gastroenterology, Department of Medicine, Taipei Veterans

General Hospital, Taipei, Taiwan.

OBJECTIVE: Propranolol is known to decrease portal pressure in cirrhotic

patients with portal hypertension; however, a substantial number of patients

do not respond to propranolol administration. The addition of

isosorbide-5-mononitrate may enhance portal pressure reduction in patients

receiving propranolol. Carvedilol is a nonselective beta-blocker with

alpha(1)-adrenergic blocking activity. It has been shown to decrease portal

pressure in cirrhotic patients. Additionally, carvedilol has a greater

portal hypotensive effect than propranolol alone in patients with cirrhosis.

The current study is aimed at comparing the acute hemodynamic effects of

carvedilol with the effects of propranolol plus isosorbide-5-mononitrate in

patients with viral cirrhosis. METHODS: Patients with viral cirrhosis were

randomly assigned to receive an oral administration of carvedilol of 25 mg

(n = 11) or an oral administration of propranolol 40 mg plus

isosorbide-5-mononitrate 20 mg (n = 11). Hemodynamic values were measured at

basal and 90 min after drugs administration. RESULTS: Both carvedilol and

propranolol plus isosorbide-5-mononitrate significantly decreased cardiac

index, heart rate, and HVPG. The magnitude of changes in HVPG observed

between the basal and after drugs administration was greater in patients

receiving carvedilol than in those receiving propranolol plus

isosorbide-5-mononitrate (-18.6 +/- 3.6%vs-10.1 +/- 3.6%, p < 0.05). Hepatic

blood flow increased following carvedilol administration but remained

unchanged in patients receiving propranolol plus isosorbide-5-mononitrate.

The magnitude of decrease in mean arterial pressure (MAP) did not differ

between the two groups of patients. CONCLUSION: In our patients with viral

cirrhosis, carvedilol is more effective than propranolol plus

isosorbide-5-mononitrate in the reduction of HVPG. Carvedilol administration

causes an increase in hepatic blood flow, but its systemic effects were

similar to those of propranolol plus isosorbide-5-mononitrate.

PMID: 15447755 [PubMed - in process

[Guest guest]

Am J Gastroenterol. 2004 Oct;99(10):1953-8.

Acute Administration of Carvedilol is More Effective than Propranolol Plus

Isosorbide-5-Mononitrate in the Reduction of Portal Pressure in Patients

with Viral Cirrhosis.

Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD.

Division of Gastroenterology, Department of Medicine, Taipei Veterans

General Hospital, Taipei, Taiwan.

OBJECTIVE: Propranolol is known to decrease portal pressure in cirrhotic

patients with portal hypertension; however, a substantial number of patients

do not respond to propranolol administration. The addition of

isosorbide-5-mononitrate may enhance portal pressure reduction in patients

receiving propranolol. Carvedilol is a nonselective beta-blocker with

alpha(1)-adrenergic blocking activity. It has been shown to decrease portal

pressure in cirrhotic patients. Additionally, carvedilol has a greater

portal hypotensive effect than propranolol alone in patients with cirrhosis.

The current study is aimed at comparing the acute hemodynamic effects of

carvedilol with the effects of propranolol plus isosorbide-5-mononitrate in

patients with viral cirrhosis. METHODS: Patients with viral cirrhosis were

randomly assigned to receive an oral administration of carvedilol of 25 mg

(n = 11) or an oral administration of propranolol 40 mg plus

isosorbide-5-mononitrate 20 mg (n = 11). Hemodynamic values were measured at

basal and 90 min after drugs administration. RESULTS: Both carvedilol and

propranolol plus isosorbide-5-mononitrate significantly decreased cardiac

index, heart rate, and HVPG. The magnitude of changes in HVPG observed

between the basal and after drugs administration was greater in patients

receiving carvedilol than in those receiving propranolol plus

isosorbide-5-mononitrate (-18.6 +/- 3.6%vs-10.1 +/- 3.6%, p < 0.05). Hepatic

blood flow increased following carvedilol administration but remained

unchanged in patients receiving propranolol plus isosorbide-5-mononitrate.

The magnitude of decrease in mean arterial pressure (MAP) did not differ

between the two groups of patients. CONCLUSION: In our patients with viral

cirrhosis, carvedilol is more effective than propranolol plus

isosorbide-5-mononitrate in the reduction of HVPG. Carvedilol administration

causes an increase in hepatic blood flow, but its systemic effects were

similar to those of propranolol plus isosorbide-5-mononitrate.

PMID: 15447755 [PubMed - in process

[Guest guest]

Am J Gastroenterol. 2004 Oct;99(10):1953-8.

Acute Administration of Carvedilol is More Effective than Propranolol Plus

Isosorbide-5-Mononitrate in the Reduction of Portal Pressure in Patients

with Viral Cirrhosis.

Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD.

Division of Gastroenterology, Department of Medicine, Taipei Veterans

General Hospital, Taipei, Taiwan.

OBJECTIVE: Propranolol is known to decrease portal pressure in cirrhotic

patients with portal hypertension; however, a substantial number of patients

do not respond to propranolol administration. The addition of

isosorbide-5-mononitrate may enhance portal pressure reduction in patients

receiving propranolol. Carvedilol is a nonselective beta-blocker with

alpha(1)-adrenergic blocking activity. It has been shown to decrease portal

pressure in cirrhotic patients. Additionally, carvedilol has a greater

portal hypotensive effect than propranolol alone in patients with cirrhosis.

The current study is aimed at comparing the acute hemodynamic effects of

carvedilol with the effects of propranolol plus isosorbide-5-mononitrate in

patients with viral cirrhosis. METHODS: Patients with viral cirrhosis were

randomly assigned to receive an oral administration of carvedilol of 25 mg

(n = 11) or an oral administration of propranolol 40 mg plus

isosorbide-5-mononitrate 20 mg (n = 11). Hemodynamic values were measured at

basal and 90 min after drugs administration. RESULTS: Both carvedilol and

propranolol plus isosorbide-5-mononitrate significantly decreased cardiac

index, heart rate, and HVPG. The magnitude of changes in HVPG observed

between the basal and after drugs administration was greater in patients

receiving carvedilol than in those receiving propranolol plus

isosorbide-5-mononitrate (-18.6 +/- 3.6%vs-10.1 +/- 3.6%, p < 0.05). Hepatic

blood flow increased following carvedilol administration but remained

unchanged in patients receiving propranolol plus isosorbide-5-mononitrate.

The magnitude of decrease in mean arterial pressure (MAP) did not differ

between the two groups of patients. CONCLUSION: In our patients with viral

cirrhosis, carvedilol is more effective than propranolol plus

isosorbide-5-mononitrate in the reduction of HVPG. Carvedilol administration

causes an increase in hepatic blood flow, but its systemic effects were

similar to those of propranolol plus isosorbide-5-mononitrate.

PMID: 15447755 [PubMed - in process