The effect of propranolol on hepatic hemodynamics in patients with cirrhosis

Abstract

The effects on portal pressure and hepatic blood flow of intravenous and oral administration of propranolol were studied in 10 patients with cirrhosis. The wedged and free hepatic venous pressure were measured by hepatic vein catheterization. Portal pressure was expressed as the gradient between the wedged and free hepatic venous pressure (Hepatic venous pressure gradient: HVPG). Estimated hepatic blood flow (EHBF) was assessed by the indocyanine green continous infusion method.
Both intravenous and oral administration of proranolol significantly reduced HVPG and EHBF. There was significant correlation between the decrease in HVPG and decrease in EHBF after propranolol. In 4 patients whose basal EHBF were below 0.5l/min/mm²2, the decrease in EHBF after propranolol was small.
It is suggested that, in patients with cirrhosis, (a) propranolol reduces the hepatic blood flow and lowers the portal pressure, and (b) these effects may be smaller in patients with a marked decrease of basal hepatic blood flow.