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Researchers at Autonomous University publish new data on variceal bleeding
2009 AUG 10 - (NewsRx.com) -- "Studies of variceal bleeding have shown that a hemodynamic response to treatment of portal hypertension is appropriate when the hepatic venous pressure gradient (HVPG) decreases below 12 mmHg or by >20% from baseline. However, in primary prophylaxis, many nonresponders do not bleed and 2 invasive procedures are needed to assess response," scientists in Barcelona, Spain report. "We investigated the long-term prognostic value of an acute response to beta-blockers and whether the target reduction in HVPG can be improved in primary prophylaxis. An initial hemodynamic study was performed in patients with large varices and without previous bleeding. After baseline measurements were made, propranolol was administered intravenously and measurements were repeated 20 minutes later. were given nadolol daily and a second hemodynamic study was performed. Of 105 patients, 15% had variceal bleeding. Using receiver operating characteristic curve analysis, a decrease of HVPG >= 10% was the best value to predict bleeding. In the initial study, 75 patients (71%) were responders (HVPG decreased to <= 12 mmHg or by >= 10%) and had a lower probability of first bleeding than nonresponders (4% vs 46% at 24 months; P< .001). Acute responders also had a lower risk of developing ascites (P = .001). Chronic responders had a lower probability of bleeding than nonresponders (P < .001). There was a correlation between acute and chronic changes in HVPG (r = 0.62; P = .01). The acute hemodynamic response to beta-blockers can be used to predict the long-term risk of first bleeding. An HVPG reduction > 10% from baseline is the best target to define response in primary prophylaxis," wrote C. Villanueva and colleagues, Autonomous University. The researchers concluded: "To view this article's video abstract, go to the AGA's YouTube Channel.." Villanueva and colleagues published their study in Gastroenterology (Acute Hemodynamic Response to beta-Blockers and Prediction of Long-term Outcome in Primary Prophylaxis of Variceal Bleeding. Gastroenterology, 2009;137(1):119-128). For additional information, contact C. Villanueva, Autonomous University Barcelona, Hospital de la Santa Creu & St. Pau, Dept. of Gastroenterology, Gastrointestinal Bleeding Unit, Service Patol Digestive, Avgda Sant Antoni M Claret 167, Barcelona 08025, Spain. The publisher's contact information for the journal Gastroenterology is: W B Saunders Co-Elsevier Inc., 1600 John F Kennedy Boulevard, Ste. 1800, Philadelphia, PA 19103-2899, USA. Keywords: Spain, Barcelona, Drugs, Gastroenterology, Hepatology, Nadolol, Pharmaceuticals, Portal Hypertension, Propranolol Hydrochloride, Therapy, Treatment, Variceal Bleeding, Varicose Vein, Autonomous University. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.
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