Hemodynamic evaluation of isosorbide dinitrate in alcoholic cirrhosis
1987; Elsevier BV; Volume: 93; Issue: 3 Linguagem: Inglês
10.1016/0016-5085(87)90921-8
ISSN1528-0012
AutoresAndrés T. Blei, Guadalupe García–Tsao, Roberto J. Groszmann, Peter J. Kahrilas, Daniel Ganger, Steve Morse, Ho‐Leung Fung,
Tópico(s)Hemodynamic Monitoring and Therapy
ResumoIsosorbide dinitrate, a long-acting organic nitrate, has been shown to decrease portal pressure in the experimental animal and humans.We conducted a double-blind randomized hemodynamic evaluation of the effects of placebo and 10 mg and 20 mg isosorbide dinitrate in stable individuals with alcoholic cirrhosis.Baseline values for all three groups were similar.Isosorbide dinitraie resulted in a peak reduction of the hepatic venous gradient of 24.7% + 3.0% with significantly decreased values 4 h after the administration of the 20-mg dose.A reduction of arterial pressure and cardiac index (peak decrease of 25.7% ?1.5%) was well tolerated by 13 of 15 patients.Changes in mecm arterial pressure were not predictive of modifications in the hepatic vein wedge pressure.There was no relation between the area under the plasma isosorbide dinitrate concentration curve and hemodynamic changes.Levels of isosorbide-5-mononitrate, a vasoactive metabolite, were detectable for an 8-h period.Isosorbide dinitpate significantly reduced portal pressure in stable
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