Dr. J. Bosch is the recipient of a grant from the Comisión Assesora, Ministerio de Educación Ciencia.
Effects of Propranolol on Azygos Venous Blood Flow and Hepatic and Systemic Hemodynamics in Cirrhosis
Article first published online: 24 JUL 2008
Copyright © 1984 American Association for the Study of Liver Diseases
Volume 4, Issue 6, pages 1200–1205, November-December 1984
How to Cite
Bosch, J., Masti, R., Kravetz, D., Bruix, J., Gaya, J., Rigau, J. and Rodes, J. (1984), Effects of Propranolol on Azygos Venous Blood Flow and Hepatic and Systemic Hemodynamics in Cirrhosis. Hepatology, 4: 1200–1205. doi: 10.1002/hep.1840040617
- Issue published online: 24 JUL 2008
- Article first published online: 24 JUL 2008
- Manuscript Received: 13 SEP 1984
- Manuscript Accepted: 18 JUN 1984
The effects of propranolol on blood flow through gastroesophageal collaterals and on systemic and hepatic hemodynamies were investigated in 23 cirrhotic patients with portal hypertension. Gastroesophageal collateral blood flow was evaluated by the measurement of azygos venous blood flow by continuous thermal dilution. Azygos venous blood flow was markedly increased in these patients (544 ± 48 ml per min, as compared with 132 ± 18 ml per min in subjects without portal hypertension (p < 0.001).
Propranolol at doses achieving effective β-blockage (83 ± 5 mg) (mean ± S.E.M.) markedly reduced azygos venous blood flow (to 354 ± 34 ml per min, p < 0.001). Reduction of azygos venous blood flow (-34.2 ± 3.6%) was significantly greater (p < 0.01) than reductions in cardiac output (-22.6 ± 1.9%), hepatic venous pressure gradient (-11.5 ± 2.4%) and hepatic blood flow (-13.4 ± 7.4%). The hemodynamic effects of propranolol were not related to plasma norepinephrine levels.
Reduction of gastroesophageal collateral blood flow may be the mechanism by which oral propranolol therapy reduces the risk of repeated episodes of variceal bleeding in cirrhotic patients with portal hypertension.