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Comparison of portal vein velocity and the hepatic venous pressure gradient in assessing the acute portal hemodynamic response to propranolol in patients with cirrhosis.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2000 Oct; Vol. 95 (10), pp. 2905-9. - Publication Year :
- 2000
-
Abstract
- Objective: The aim of this prospective study was to compare noninvasive Doppler sonography and invasive measurement of the hepatic venous pressure gradient (HVPG) to determine the acute portal hemodynamic response to propranolol in patients with liver cirrhosis.<br />Methods: In a blinded study design, portal vein velocity (PVV) and HVPG were simultaneously assessed in 11 cirrhotic patients for 4 h after oral ingestion of 40 mg propranolol.<br />Results: Both HVPG (17.2% +/- 4.3%, p < 0.0001) and PVV (15.6% +/- 2.1%, p < 0.0002) showed a highly significant reduction during the study period versus baseline. Based on HVPG measurements, four patients (36%) were classified as nonresponders. These patients had a significantly lower PVV reduction compared to the responders (responders: 18.8% +/- 2.0% vs nonresponders: 10.0% +/- 2.1%, p < 0.05). Nonresponders were identified by Doppler sonography with a sensitivity of 1.0, specificity of 0.86, and positive predictive value of 0.9 when a threshold of 20% PVV reduction 120 min after drug intake was applied.<br />Conclusions: Doppler sonography is a useful tool for assessment of the acute portal hemodynamic effect of propranolol. To distinguish portal hemodynamic nonresponders from responders to propranolol, PVV measurements should be carried out 2 h after drug administration, and PVV reduction should be not <20% in propranolol responders.
- Subjects :
- Administration, Oral
Blood Flow Velocity drug effects
Blood Flow Velocity physiology
Female
Hemodynamics physiology
Hepatic Veins diagnostic imaging
Hepatic Veins physiopathology
Humans
Liver Cirrhosis diagnostic imaging
Liver Cirrhosis physiopathology
Male
Middle Aged
Portal Pressure physiology
Portal System diagnostic imaging
Portal System physiopathology
Portal Vein diagnostic imaging
Portal Vein physiopathology
Propranolol adverse effects
Sensitivity and Specificity
Treatment Outcome
Ultrasonography, Doppler drug effects
Hemodynamics drug effects
Hepatic Veins drug effects
Liver Cirrhosis drug therapy
Portal Pressure drug effects
Portal System drug effects
Portal Vein drug effects
Propranolol administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9270
- Volume :
- 95
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 11051366
- Full Text :
- https://doi.org/10.1111/j.1572-0241.2000.03202.x