Terlipressin is used in patients with variceal
bleeding but its effects in patients receiving
beta-adrenergic antagonists are unknown. In this study, the hemodynamic effects of
terlipressin were evaluated in conscious portal hypertensive rats which had previously received a single dose of
propranolol. Moreover,
oxygen content and
acid-base status were studied. In portal vein stenosed and cirrhotic rats, the addition of
terlipressin (0.05 mg/kg) to
propranolol (0.4 mg/kg) produced a decrease in portal pressure of 34% and 17%, respectively, and in portal tributary blood flow of 46% and 42%, respectively. In cirrhotic rats, however, the decrease in portal pressure was not significantly different when
propranolol was combined with
terlipressin than when
propranolol was administered alone. Cardiac index also further decreased after
terlipressin administration. In both groups of rats, these values were similar to those observed after
terlipressin alone. In portal vein stenosed rats but not in cirrhotic rats, arterial pH was significantly lower following the combination of
propranolol plus
terlipressin than following saline,
propranolol or
terlipressin alone. In conclusion,
terlipressin further reduces both portal pressure and cardiac index in rats with
portal hypertension receiving beta-blockers. In portal vein stenosed rats but not in cirrhotic rats, the addition of
terlipressin to
propranolol induces acidemia. This study suggests that
terlipressin might further reduce portal pressure in patients with
portal hypertension treated with beta-blockers.