Abstract | BACKGROUND: METHODS: The hepatic venous pressure gradient (HVPG) and portal venous velocity (PVV) were measured both before and 3 months after initiation of the administration of captopril (n = 29) or propranolol (n = 29) in cirrhotic patients with a variceal bleeding episode. Patients who showed a reduction in the HVPG of more than 20% of the baseline were defined as being responders. RESULTS: At 3 months, the mean reduction in the HVPG after captopril was less than that after propranolol (-3.0 +/- 9.3% vs -28.5% +/- 4.1%; P < 0.05). However, of the 29 patients receiving captopril, 9 were classified as being responders. On multivariate analysis with parameters including age, cause, Child-Pugh score, HVPG, and PVV, only low PVV was found to be a significant independent factor for responders (PVV < 12 cm/s; odds ratio [OR], 12.2; 95% confidence interval [CI], 1.47-102.40) in the captopril group. CONCLUSIONS: Longterm captopril administration reduces the portal pressure effectively in cirrhotic patients with a low PVV. This suggests that the reduction in portal pressure after captopril administration is a result of improved portal venous outflow brought about by a decrease in the intrahepatic vascular resistance. When the PVV is below 12 cm/s, a captopril trial might be useful in preventing variceal bleeding in portal hypertensive patients.
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Authors | Soon Koo Baik, Dong Hun Park, Moon Young Kim, Yeun Jong Choi, Hyun Soo Kim, Dong Ki Lee, Sang Ok Kwon, Young Ju Kim, Joong Wha Park, Sei Jin Chang |
Journal | Journal of gastroenterology
(J Gastroenterol)
Vol. 38
Issue 12
Pg. 1150-4
( 2003)
ISSN: 0944-1174 [Print] Japan |
PMID | 14714252
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- Antihypertensive Agents
- Captopril
- Propranolol
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Topics |
- Angiotensin-Converting Enzyme Inhibitors
(administration & dosage)
- Antihypertensive Agents
(administration & dosage)
- Blood Flow Velocity
(physiology)
- Captopril
(administration & dosage)
- Drug Administration Schedule
- Female
- Humans
- Hypertension, Portal
(complications, drug therapy, physiopathology)
- Liver Cirrhosis
(complications, physiopathology)
- Male
- Middle Aged
- Portal Pressure
(drug effects)
- Portal Vein
(physiopathology)
- Propranolol
(administration & dosage)
- Prospective Studies
- Time Factors
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