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http://dx.doi.org/10.25673/38497
Titel: | Effect of ET-A blockade on portal pressure and hepatic arterial perfusion in patients with cirrhosis : a proof of concept study |
Autor(en): | Zipprich, Alexander Gittinger, Fleur Sophie Winker, Matthias Dollinger, Matthias Ripoll, Cristina |
Erscheinungsdatum: | 2021 |
Art: | Artikel |
Sprache: | Englisch |
Zusammenfassung: | Background/aim: Endothelin causes vasoconstriction via the endothelin-A receptor (ET-A) in the intrahepatic circulation in cirrhosis and its increase leads to portal hypertension. The aim of the study was to investigate the acute effect of a selective ET-A antagonist in patients with portal hypertension and cirrhosis. Methods: Proof-of-concept study with two different substudies: (a) local intrahepatic administration of the ET-A antagonist BQ 123 and (b) systemic oral administration of the ET-A antagonist Ambrisentan. Portal pressure was determined by hepatic venous pressure gradient (HVPG, both substudies) and hepatic arterial blood flow (HABF) by intra-arterial Doppler measurements (substudy 1) before and under the ET-A antagonist. Systemic haemodynamic parameters were measured in substudy 2. Results: Twelve patients (Child-Pugh [CP] B/C n = 7/5) were included in substudy 1 and 14 patients (CP A/B/C n = 4/6/4) in substudy 2. The relative decrease in HVPG was −12.5% (IQR: −40% to 0%; P = .05) in substudy 1 and −5.0% (IQR: −11.5% to 0%; P = .01) in substudy 2. Substudy 1 revealed higher decrease in HVPG in CP B patients. HABF increased significantly and patients without portal pressure decrease showed a higher increase of HABF. Substudy 2 showed a slight decrease in the mean arterial pressure without changes of other systemic haemodynamic parameters. Conclusion: Administration of a selective ET-A antagonist decreases the portal pressure in cirrhotic patients. This decrease was higher in CP B patients and the non-responders showed a higher increase in hepatic arterial flow. Selective ET-A antagonists might be a future treatment option in patients with portal hypertension. |
URI: | https://opendata.uni-halle.de//handle/1981185920/38743 http://dx.doi.org/10.25673/38497 |
Open-Access: | Open-Access-Publikation |
Nutzungslizenz: | (CC BY-NC 4.0) Creative Commons Namensnennung - Nicht kommerziell 4.0 International |
Sponsor/Geldgeber: | Publikationsfond MLU |
Journal Titel: | Liver international |
Verlag: | Wiley-Blackwell |
Verlagsort: | Oxford |
Band: | 41 |
Heft: | 3 |
Originalveröffentlichung: | 10.1111/liv.14757 |
Seitenanfang: | 554 |
Seitenende: | 561 |
Enthalten in den Sammlungen: | Open Access Publikationen der MLU |
Dateien zu dieser Ressource:
Datei | Beschreibung | Größe | Format | |
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liv.14757.pdf | 496.33 kB | Adobe PDF | Öffnen/Anzeigen |