The effects of propranolol on portal pressure in cirrhotic patients with portal hypertension

Background : Propranolol is only known drug effective in preventing variceal bleeing by ameliorating portal hypertension. The optimal of propranolol is variable due to racial differences of cardiovascular receptor sensitivity. In this. prospective study, we tried to evaluate the effect of propranolol on protal hypertension, required optimal dose and to find out factors that influence drug responses in Korean cirrhotic patioents with portal hypertension. Methods : This study included 25 patients with liver cirrhosis who had variceal bleeding episode. Propranolol was given orally at an initial dose of 20 mg twice daily. The dose was subsequently adjusted over a period of 2 days until the resting heart rate had been reduced by 25% or less than 55 beats per minute. The homodynamic studies including measurernents of heart rate (HR), mean blood pressure (MBP), hepatic venous pressure gradient (HVPG), portal venous flow (PVF) were evaluated both prior to and 3 months after commencing treatment. Patients who showed a reduction in HPVG of more than 20% of baseline or absolute value under 12 mrnHg were defined as being responders. Results : The mean required dose of propranolol to reach target heart rate was 165 mg (80-280mg). Propranolol induced significant reduction in HVPG (-29.021.4%, p17.8%, p9.1%, p