POSTPRANDIAL VASCULAR-RESPONSE IN PATIENTS WITH CIRRHOSIS - SHORT-TERM EFFECTS OF PROPRANOLOL ADMINISTRATION

Systemic and portal hemodynamic parameters were evaluated in eight cir rhotic patients in basal conditions and after food intake and placebo. Following seven days of oral propranolol administration, hemodynamic parameters were reevaluated in thefasting and postprandial states unde r similar conditions. Cardiac output and portal blood pow were measure d by Doppler technique. Intraobserver variability of repeated measurem ents was less than 10%. Food intake caused a significant increase of p ortal bloodflow (+28%, P < 0.05). No significant changes were observed in the other hemodynamic parameters studied. Propranolol at doses ach ieving effective beta blockade (84 +/- 14 mg/day) (mean +/- SD) reduce d portal blood flow (-24%, P < 0.05). Food intake caused a significant increase in portal blood flow (+35%, P < 0.05) in propranolol treated patients. However, in absolute values, postprandial portal blood flow during propranolol treatment was significantly lower (986 +/- 402 ml/ min) than that obtained after the initial food intake (1214 +/- 537 ml /min, P < 0.05). Placebo administration had no significant hemodynamic effects in either group. This study demonstrates that chronic propran olol administration could protect from portal hemodynamic changes foll owing food intake. Doppler technique is a reliable technique to evalua te changes on portal and systemic hemodynamic parameters during a shor t period of time in patients with cirrhosis.