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
DOI: 10.3748/wjg.v24.i3.438
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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