Hemodynamic Evaluation of Nonselective β-Blockers in Patients with Cirrhosis and Refractory Ascites
Joint Authors
Burra, Patrizia
Tikhonoff, Valérie
Russo, Francesco Paolo
Ferrarese, Alberto
Angeli, Paolo
Fasolato, Silvano
Faggian, Diego
Zanetto, Alberto
Germani, Giacomo
Senzolo, Marco
Casiglia, Edoardo
Source
Gastroenterology Research and Practice
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-05-09
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Nonselective β-blockers (NSBB) have been associated with increased incidence of paracentesis-induced circulatory dysfunction (PICD) and reduced survival in patients with cirrhosis and refractory ascites.
Aim.
To prospectively evaluate a hemodynamic response to NSBB in cirrhotics listed for liver transplantation with refractory ascites undergoing large volume paracentesis (LVP).
Methods.
Patients with cirrhosis and refractory ascites, with an indication to start NSBB in primary prophylaxis for variceal bleeding, were enrolled.
During two consecutive LVP, while being, respectively, off and on NSBB, cardiac output (CO), systemic vascular resistances (SVR), peripheral vascular resistances (PVR), and plasma renin activity (PRA) were noninvasively assessed.
Results.
Seventeen patients were enrolled, and 10 completed the study.
Before NSBB introduction, SVR (1896 to 1348 dyn·s·cm−5; p=0.028) and PVR (47 to 30 mmHg·min·dl·ml−1; p=0.04) significantly decreased after LVP, while CO showed an increasing trend (3.9 to 4.5 l/m; p=0.06).
After NSBB introduction, LVP was not associated with a significant increase in CO (3.4 to 3.8 l/m; p=0.13) nor with a significant decrease in SVR (2002 versus 1798 dyn·s·cm−5; p=0.1).
Incidence of PICD was not increased after NSBB introduction.
Conclusion.
The negative inotropic effect of NSBB was counterbalanced by a smaller decrease of vascular resistances after LVP, probably due to splanchnic β2-blockade.
This pilot study showed that NSBB introduction may be void of detrimental hemodynamic effects after LVP in cirrhotics with refractory ascites.
American Psychological Association (APA)
Ferrarese, Alberto& Tikhonoff, Valérie& Casiglia, Edoardo& Angeli, Paolo& Fasolato, Silvano& Faggian, Diego…[et al.]. 2018. Hemodynamic Evaluation of Nonselective β-Blockers in Patients with Cirrhosis and Refractory Ascites. Gastroenterology Research and Practice،Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1159602
Modern Language Association (MLA)
Ferrarese, Alberto…[et al.]. Hemodynamic Evaluation of Nonselective β-Blockers in Patients with Cirrhosis and Refractory Ascites. Gastroenterology Research and Practice No. 2018 (2018), pp.1-7.
https://search.emarefa.net/detail/BIM-1159602
American Medical Association (AMA)
Ferrarese, Alberto& Tikhonoff, Valérie& Casiglia, Edoardo& Angeli, Paolo& Fasolato, Silvano& Faggian, Diego…[et al.]. Hemodynamic Evaluation of Nonselective β-Blockers in Patients with Cirrhosis and Refractory Ascites. Gastroenterology Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-7.
https://search.emarefa.net/detail/BIM-1159602
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1159602