Usefulness of angiotensin II receptor antagonist losartan in patients with portal hypertensive gastropathy.

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Hepatogastroenterology. 2006 Mar-Apr;53(68):171-4.

Clinical usefulness of the angiotensin

II receptor antagonist losartan in patients with

portal hypertensive gastropathy.

Wagatsuma

Y, Naritaka

Y, Shimakawa

T, Kanako

H, Keiichiro

I, Shunichi

S, Konno

S, Katsube

T, Ogawa

K.

Depart of Surgery, Tokyo Women's Medical

University Medical

Center East, Tokyo,

Japan.

BACKGROUND/AIMS: An elevated portal vein pressure is an important factor in the

onset of portal hypertensive gastropathy associated

with liver cirrhosis, and propranolol or vasopressin (drugs

with a portal hypotensive effect) are used to

treat this problem. It has been reported that angiotensin

II receptor antagonists, which were developed as antihypertensive agents, also

have a portal hypotensive effect, but their

usefulness for portal hypertensive gastropathy is

unclear. In this study, the angiotensin II receptor

antagonist losartan was administered to 16 portal

hypertensive gastropathy patients, and its clinical

usefulness was examined. METHODOLOGY: Losartan was

administered once a day after breakfast at a dose of 25mg or 50mg. The effect

on portal hypertensive gastropathy was evaluated from

the endoscopic findings at baseline and after 4 weeks

of administration. And changes of portal hemodynamics

were monitored by pulse Doppler ultrasonography at

baseline and after 4 weeks of administration. RESULTS: Portal hypertensive gastropathy was found to have improved in nine out of 16

patients for an efficacy rate of 56%. The efficacy rate in the 50mg group (n=6)

was 83%, and was higher than the rate of 40% in the 25mg group (n = 10). The

mean portal vein blood flow velocity was found to increase significantly, while

the congestion index decreased significantly, supporting evidence of a decrease

in portal pressure. CONCLUSIONS: Losartan may become one of the effective treatments for

portal hypertensive gastropathy in the future.

PMID: 16608017 [PubMed - in process]