Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up
| Autor: | Martin Rössle, Wolfgang Kreisel, Peter Deibert, Denise Schaffner, Adhara Lazaro, Zoran Stankovic |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Liver Cirrhosis
Time Factors Cirrhosis medicine.drug_mechanism_of_action Computed Tomography Angiography Portal venous pressure Administration Oral Case Report Gastroenterology Tadalafil 0302 clinical medicine Esophageal varices Endoscopy Digestive System Portal hypertension 610 Medicine & health Syndrome General Medicine Middle Aged Hepatitis Autoimmune Treatment Outcome Liver hemodynamics 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage Phosphodiesterase 5 inhibitor medicine.drug medicine.medical_specialty Cholangitis Sclerosing Phosphodiesterase-5 Esophageal and Gastric Varices 03 medical and health sciences Magnetic resonance imaging Vardenafil Dihydrochloride Internal medicine Hypertension Portal medicine Humans business.industry Hemodynamics Phosphodiesterase 5 Inhibitors medicine.disease Vardenafil Varices business Follow-Up Studies Doppler sonography |
| Zdroj: | Deibert, Peter; Lazaro, Adhara; Stankovic, Zoran; Schaffner, Denise; Rössle, Martin; Kreisel, Wolfgang (2018). Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up. World journal of gastroenterology, 24(3), pp. 438-444. WJG Press 10.3748/wjg.v24.i3.438 World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| Popis: | Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis. |
| Databáze: | OpenAIRE |
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