Octreotide enhances portal pressure reduction induced by propranolol in cirrhosis: a randomized, controlled trial.

Autor:	Vorobioff JD; Liver Unit and Hepatic Hemodynamic Laboratory, Sanatorio Parque, and Hospital Provincial del Centenario, Rosario, Argentina., Ferretti SE, Zangroniz P, Gamen M, Picabea E, Bessone FO, Reggiardo V, Diez AR, Tanno M, Cuesta C, Tanno HE
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2007 Oct; Vol. 102 (10), pp. 2206-13. Date of Electronic Publication: 2007 Jun 29.
DOI:	10.1111/j.1572-0241.2007.01390.x
Abstrakt:	Background: In vitro, octreotide potentiates vasoconstriction in isolated, preconstricted, mesenteric arterial vessels. In cirrhotic patients, portal pressure (HVPG) reduction induced by propranolol is partly due to splanchnic vasoconstriction. Aim: To evaluate HVPG effects of octreotide administration in cirrhotic patients receiving long-term propranolol. Patients and Methods: A randomized, controlled trial. First study: a total of 28 patients were studied at baseline and 30 and 60 minutes after octreotide (200 mug) (N = 14) or placebo (N = 14) and then treated with propranolol for approximately 30 days (106 +/- 5 mg/day). Second study: after baseline evaluation patients received octreotide or placebo as they were assigned to in the first study and measurements repeated 30 and 60 minutes later. Results: In the first study baseline HVPG was 18.7 +/- 0.9 mmHg and decreased to 17.1 +/- 1.1 mmHg and 17.1 +/- 1.0 mmHg (both P < 0.05 vs baseline) at 30 and 60 minutes after octreotide, respectively. Eight patients decreased their HVPG after octreotide. In the second study baseline HVPG was 15.6 +/- 1.3 mmHg (P < 0.01 vs baseline HVPG in first study) and decreased to 14.1 +/- 1.2 mmHg and 14.1 +/- 1.3 mmHg (25.7 +/- 5% lower than baseline HVPG in the first study, P < 0.01) (both P < 0.05 vs baseline) at 30 and 60 minutes after octreotide, respectively. Nine patients (2 responders/7 nonresponders to propranolol) decreased their HVPG after octreotide. Octreotide effects may be mediated by potentiation and additive mechanisms. Conclusions: Octreotide enhances HVPG reduction induced by propranolol in cirrhotic patients.
Databáze:	MEDLINE
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