Beta-blockers in liver cirrhosis

Annals of Gastroenterology

Volumn 27, Issue 1, 2014, Pages 20-26

  Giannelli, Valerio ^a   Lattanzi, Barbara ^a   Thalheimer, Ulrich ^b   Merli, Manuela ^a  

^a SAPIENZA UNIVERSITY OF ROME   (Italy)

^b ROYAL DEVON AND EXETER NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Blockers; Carvedilol; Cirrhosis; HVPG; Nadolol; Portal hypertension; Propranolol; Variceal bleeding

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CARVEDILOL; ISOSORBIDE MONONITRATE; NADOLOL; NON SELECTIVE BETA BLOCKER; PROPRANOLOL; UNCLASSIFIED DRUG;

ANTI ALPHA 1 ADRENERGIC ACTIVITY; ASCITES; BACTERIAL PERITONITIS; BACTERIAL TRANSLOCATION; CHEMOPROPHYLAXIS; DRUG ACTIVITY; DRUG DOSE INCREASE; DRUG DOSE TITRATION; DRUG EFFECT; DRUG MECHANISM; ENDOSCOPIC VARICEAL LIGATION; ESOPHAGUS VARICES BLEEDING; HEMODYNAMICS; HEPATIC ENCEPHALOPATHY; HEPATOVENOUS PRESSURE GRADIENT; HUMAN; LIVER CIRRHOSIS; LOW DRUG DOSE; NONHUMAN; OVERALL SURVIVAL; PORTAL HYPERTENSION; PORTAL VEIN BLOOD PRESSURE; PRACTICE GUIDELINE; PRESSURE GRADIENT; PRIMARY PREVENTION; REVIEW; RISK REDUCTION; SECONDARY PREVENTION; TREATMENT CONTRAINDICATION; TREATMENT RESPONSE; UNSPECIFIED SIDE EFFECT; VEIN LIGATION;

EID: 84890952737     PISSN: 11087471     EISSN: 17927463     Source Type: Journal    
DOI: None     Document Type: Review

References (96)

1. Lebrec D, Nouel O, Corbic M, Benhamou JP. Propranolol-a medical treatment for portal hypertension? Lancet 1980;26:180-182.
2. Lebrec D, Poynard T, Hillon P, Benhamou JP. Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a controlled study. N Engl J Med 1981;305:1371-1374.
3. The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multi-center study. N Engl J Med 1988;319:983-989.
4. Bosch J. Medical treatment of portal hypertension. Digestion 1998;59:547-555.
5. D'Amico G, Pagliaro L, Bosch J. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin Liver Dis 1999;19:475-505.
6. Pagliaro L, D'Amico G, Sörensen TI, et al. Prevention of first bleeding in cirrhosis. A meta-analysis of randomized trials of nonsurgical treatment. Ann Intern Med 1992;117:59-70.
7. Bernard B, Lebrec D, Mathurin P, Opolon P, Poynard T. Betaadrenergic antagonists in the prevention of gastrointestinal rebleeding in patients with cirrhosis: a meta-analysis. Hepatology 1997;25:63-70.
8. D'Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology 1995;22:332-354.
9. García-Pagán JC, Escorsell A, Moitinho E, Bosch J. Influence of pharmacological agents on portal hemodynamics: basis for its use in the treatment of portal hypertension. Semin Liver Dis 1999;19:427-438.
10. Bosch J, Pizcueta P, Feu F, Fernández M, García-Pagán JC. Pathophysiology of portal hypertension. Gastroenterol Clin North Am 1992;21:1-14.
11. Kroeger RJ, Groszmann RJ. The effect of the combination of nitroglycerin and propranolol on splanchnic and systemic hemodynamics in a portal hypertensive rat model. Hepatology 1985;5:425-430.
12. Bołdys H, Hartleb M, Rudzki K, Nowak A, Nowak S. Effect of propranolol on portosystemic collateral circulation estimated by per-rectal portal scintigraphy with technetium-99m pertechnetate. J Hepatol 1995;22:173-178.
13. Feu F, Bordas JM, Luca A, et al. Reduction of variceal pressure by propranolol: comparison of the effects on portal pressure and azygos blood flow in patients with cirrhosis. Hepatology 1993;18:1082-1089.
14. Andreu V, Perello A, Moitinho E, et al. Total effective vascular compliance in patients with cirrhosis. Effects of propranolol. J Hepatol 2002;36:356-361.
15. Thalheimer U, Leandro G, Samonakis DN, Triantos CK, Patch D, Burroughs AK. Assessment of the agreement between wedge hepatic vein pressure and portal vein pressure in cirrhotic patients. Dig Liver Dis 2005;37:601-608.
16. Perelló A, Escorsell A, Bru C, et al. Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus-related cirrhosis. Hepatology 1999;30:1393-1397.
17. Garcia-Tsao G, Groszmann RJ, Fisher RL, Conn HO, Atterbury CE, Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology 1985;5:419-424.
18. Bosch J, Abraldes JG, Groszmann R. Current management of portal hypertension. J Hepatol 2003;38:S54-S68.
19. Feu F, García-Pagán JC, Bosch J, et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet 1995;346:1056-1059.
20. De Franchis R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol 2010;53:762-768.
21. Lin HC, Soubrane O, Cailmail S, Lebrec D. Early chronic administration of propranolol reduces the severity of portal hypertension and portal-systemic shunts in conscious portal vein stenosed rats. J Hepatol 1991;13:213-219.
22. Sarin SK, Groszmann RJ, Mosca PG, et al. Propranolol ameliorates the development of portal-systemic shunting in a chronic murine schistosomiasis model of portal hypertension. J Clin Invest 1991;87:1032-1036.
23. Calés P, Oberti F, Payen JL, et al. Lack of effect of propranolol in the prevention of large oesophageal varices in patients with cirrhosis: a randomized trial. French-Speaking Club for the Study of Portal Hypertension. Eur J Gastroenterol Hepatol 1999;11:741-745.
24. Merkel C, Marin R, Angeli P, et al. A placebo-controlled clinical trial of nadolol in the prophylaxis of growth of small esophageal varices in cirrhosis. Gastroenterology 2004;127:476-484.
25. Groszmann RJ, Garcia-Tsao G, Bosch J, et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med 2005;353:2254-2261.
26. Nevens F, Bustami R, Scheys I, Lesaffre E, Fevery J. Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology 1998;27:15-19.
27. De Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol 2005;43:167-176.
28. Gonzalez R, Zamora J, Gomez-Camarero J, Molinero LM, Bañares R, Albillos A. Meta-analysis: Combination endoscopic and drug therapy to prevent variceal rebleeding in cirrhosis. Ann Intern Med 2008;149:109-122.
29. Bosch J. Carvedilol for portal hypertension in patients with cirrhosis. Hepatology 2010;51:2214-2218.
30. Bañares R, Moitinho E, Piqueras B, et al. Carvedilol, a new nonselective beta-blocker with intrinsic anti-Alpha1-adrenergic activity, has a greater portal hypotensive effect than propranolol in patients with cirrhosis. Hepatology 1999;30:79-83.
31. Watanabe K, Ohta Y, Nakazawa M, et al. Low dose carvedilol inhibits progression of heart failure in rats with dilated cardiomyopathy. Br J Pharmacol 2000;130:1489-1495.
32. Dalla Libera L, Ravara B, Gobbo V, et al. Skeletal muscle myofibrillar protein oxidation in heart failure and the protective effect of Carvedilol. J Mol Cell Cardiol 2005;38:803-807.
33. Nanjo S, Yamazaki J, Yoshikawa K, Ishii T, Togane Y. Carvedilol prevents myocardial fibrosis in hamsters. Int Heart J 2006;47:607-616.
34. Ronsein GE, Guidi DB, Benassi JC, Filho DW, Pedrosa RC, Pedrosa RC. Cytoprotective effects of carvedilol against oxygen free radical generation in rat liver. Redox Rep 2005;10:131-137.
35. Hamdy N, El-Demerdash E. New therapeutic aspect for carvedilol: antifibrotic effects of carvedilol in chronic carbon tetrachlorideinduced liver damage. Toxicol Appl Pharmacol 2012;261:292-299.
36. Forrest EH, Bouchier IA, Hayes PC. Acute haemodynamic changes after oral carvedilol, a vasodilating beta-blocker, in patients with cirrhosis. J Hepatol 1996;25:909-915.
37. Bruha R, Vitek L, Petrtyl J, et al. Effect of carvedilol on portal hypertension depends on the degree of endothelial activation and inflammatory changes. Scand J Gastroenterol 2006;41:1454-1463.
38. Lin HC, Yang YY, Hou MC, Huang YT, Lee FY, Lee SD. Acute administration of carvedilol is more effective than propranolol plus isosorbide-5-mononitrate in the reduction of portal pressure in patients with viral cirrhosis. Am J Gastroenterol 2004;99:1953-1958.
39. Bañares R, Moitinho E, Matilla A, et al. Randomized comparison of long-term carvedilol and propranolol administration in the treatment of portal hypertension in cirrhosis. Hepatology 2002;36:1367-1373.
40. De BK, Das D, Sen S, et al. Acute and 7-day portal pressure response to carvedilol and propranolol in cirrhotics. J Gastroenterol Hepatol 2002;17:183-189.
41. Lo GH, Chen WC, Wang HM, Yu HC. Randomized, controlled trial of carvedilol versus nadolol plus isosorbide mononitrate for the prevention of variceal rebleeding. J Gastroenterol Hepatol 2012;27:1681-1687.
42. Bosch J. Carvedilol for preventing recurrent variceal bleeding: Waiting for convincing evidence. Hepatology 2013;57:1665-1667.
43. Tripathi D, Ferguson JW, Kochar N, Leithead JA, Therapondos G, McAvoy NC, Stanley AJ, Forrest EH, Hislop WS, Mills PR, et al. Randomized controlled trial of carvedilol versus variceal band ligation for the prevention of the first variceal bleed. Hepatology 2009;50:825-833
44. Reiberger T, Ulbrich G, Ferlitsch A, et al. Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol. Gut 2013;62:1634-1641.
45. Abraldes JG, Tarantino I, Turnes J, Garcia-Pagan JC, Rodés J, Bosch J. Hemodynamic response to pharmacological treatment of portal hypertension and long-term prognosis of cirrhosis. Hepatology 2003;37:902-908.
46. Hernández-Gea V, Aracil C, Colomo A, et al. Development of ascites in compensated cirrhosis with severe portal hypertension treated with β-blockers. Am J Gastroenterol 2012;107:418-427.
47. Merli M, Lucidi C. Bacterial resistance in cirrhotic patients: an emerging reality. J Hepatol 2012;56:756-757.
48. Gustot T, Durand F, Lebrec D, Vincent JL, Moreau R. Severe sepsis in cirrhosis. Hepatology 2009;50:2022-2033.
49. Fernández J, Gustot T. Management of bacterial infections in cirrhosis. J Hepatol 2012;56:S1-S12.
50. Fasolato S, Angeli P, Dallagnese L, et al. Renal failure and bacterial infections in patients with cirrhosis: epidemiology and clinical features. Hepatology 2007;45:223-229.
51. Merli M, Lucidi C, Giannelli V, et al. Cirrhotic patients are at risk for health care-associated bacterial infections. Clin Gastroenterol Hepatol 2010;8:979-985.
52. Navasa M, Rimola A, Rodés J. Bacterial infections in liver disease. Semin Liver Dis 1997;17:323-333.
53. Soares-Weiser K, Brezis M, Tur-Kaspa R, Paul M, Yahav J, Leibovici L. Antibiotic prophylaxis of bacterial infections in cirrhotic inpatients: a meta-analysis of randomized controlled trials. Scand J Gastroenterol 2003;38:193-200.
54. Goulis J, Armonis A, Patch D, Sabin C, Greenslade L, Burroughs AK. Bacterial infection is independently associated with failure to control bleeding in cirrhotic patients with gastrointestinal hemorrhage. Hepatology 1998;27:1207-1212.
55. Hou MC, Lin HC, Liu TT, et al. Antibiotic prophylaxis after endoscopic therapy prevents rebleeding in acute variceal hemorrhage: a randomized trial. Hepatology 2004;39:746-753.
56. Arvaniti V, D'Amico G, Fede G. Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology 2010;139:1246-1256.
57. Berg RD, Garlington AW. Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model. Infect Immun 1979;23:403-411.
58. Wiest R, Garcia-Tsao G. Bacterial translocation (BT) in cirrhosis. Hepatology 2005;41:422-433.
59. Thalheimer U, Triantos CK, Samonakis DN, Patch D, Burroughs AK. Infection, coagulation, and variceal bleeding in cirrhosis. Gut 2005;54:556-563.
60. Sanders VM, Straub RH. Norepinephrine, the beta-adrenergic receptor, and immunity. Brain Behav Immun 2002;16:290-332.
61. Freestone PP, Williams PH, Haigh RD, Maggs AF, Neal CP, Lyte M. Growth stimulation of intestinal commensal Escherichia coli by catecholamines: a possible contributory factor in traumainduced sepsis. Shock 2002;18:465-470.
62. Green BT, Lyte M, Chen C, et al. Adrenergic modulation of Escherichia coli O157:H7 adherence to the colonic mucosa. Am J Physiol Gastrointest Liver Physiol 2004;287:G1238-G1246.
63. Iwao T, Toyonaga A, Ikegami M, et al. Effects of vasopressin and nicardipine on hemodynamics and liver function in patients with cirrhosis: comparison with vasopressin alone. J Hepatol 1993;19:345-352.
64. Iwakiri Y, Groszmann RJ. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology 2006;43:S121-S131.
65. Pérez-Paramo M, Muñoz J, Albillos A, et al. Effect of propranolol on the factors promoting bacterial translocation in cirrhotic rats with ascites. Hepatology 2000;31:43-48.
66. Cholongitas E, Papatheodoridis GV, Manesis EK, Burroughs AK, Archimandritis AJ. Spontaneous bacterial peritonitis in cirrhotic patients: Is prophylactic propranolol therapy beneficial? J Gastroenterol Hepatol 2006;21:581-587.
67. Turnes J, Garcia-Pagan JC, Abraldes JG, Hernandez-Guerra M, Dell'Era A, Bosch J. Pharmacological reduction of portal pressure and long-term risk of first variceal bleeding in patients with cirrhosis. Am J Gastroenterol 2006;101:506-512.
68. Soylu AR, Dökmeci G, Tezel A, Amuca H, Umit H. Propranolol does not affect incidence of spontaneous bacterial peritonitis in cirrhotic patients with ascites. Am J Gastroenterol 2003;98:1446-1448.
69. Lo GH, Chen WC, Lin CK, et al. Improved survival in patients receiving medical therapy as compared with banding ligation for the prevention of esophageal variceal rebleeding. Hepatology 2008;48:580-587.
70. Senzolo M, Cholongitas E, Burra P, et al. beta-Blockers protect against spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis. Liver Int 2009;29:1189-1193.
71. Reiberger T, Ferlitsch A, Payer BA, et al. Non-selective betablocker therapy decreases intestinal permeability and serum levels of LBP and IL-6 in patients with cirrhosis. J Hepatol 2013;58:911-921.
72. Thalheimer U, Bosch J, Burroughs AK. How to prevent varices from bleeding: shades of grey--the case for nonselective beta blockers. Gastroenterology 2007;133:2029-2036.
73. Wong F, Salerno F. Beta-blockers in cirrhosis: friend and foe? Hepatology 2010;52:811-813.
74. Valeriano V, Funaro S, Lionetti R, et al. Modification of cardiac function in cirrhotic patients with and without ascites. Am J Gastroenterol 2000;95:3200-3205.
75. Merli M, Calicchia A, Ruffa A, et al. Cardiac dysfunction in cirrhosis is not associated with the severity of liver disease. Eur J Intern Med 2013;24:172-176.
76. Wong F, Girgrah N, Graba J, Allidina Y, Liu P, Blendis L. The cardiac response to exercise in cirrhosis. Gut 2001;49:268-275.
77. Møller S, Henriksen JH. Cirrhotic cardiomyopathy. J Hepatol 2010;53:179-190.
78. Ruiz-del-Arbol L, Monescillo A, Jimenéz W, Garcia-Plaza A, Arroyo V, Rodés J. Paracentesis-induced circulatory dysfunction: mechanism and effect on hepatic hemodynamics in cirrhosis. Gastroenterology 1997;113:579-586.
79. Panos MZ, Moore K, Vlavianos P, et al. Single, total paracentesis for tense ascites: sequential hemodynamic changes and right atrial size. Hepatology 1990;11:662-667.
80. Moreau R, Asselah T, Condat B, et al. Comparison of the effect of terlipressin and albumin on arterial blood volume in patients with cirrhosis and tense ascites treated by paracentesis: a randomised pilot study. Gut 2002;50:90-94.
81. Sersté T, Melot C, Francoz C, et al. Deleterious effects of betablockers on survival in patients with cirrhosis and refractory ascites. Hepatology 2010;52:1017-1022.
82. Senzolo M, Nadal E, Cholongitas E, Burroughs AK. Is hydrophobia necessary for the hepatologist prescribing nonselective betablockers in cirrhosis? Hepatology 2011;53:2149-2150.
83. Sersté T, Francoz C, Durand F, et al. Beta-blockers cause paracentesis-induced circulatory dysfunction in patients with cirrhosis and refractory ascites: a cross-over study. J Hepatol 2011;55:794-799.
84. Pozzi M, Osculati G, Boari G, et al. Time course of circulatory and humoral effects of rapid total paracentesis in cirrhotic patients with tense, refractory ascites. Gastroenterology 1994;106:709-719.
85. Ginès A, Fernández-Esparrach G, Monescillo A, et al. Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis. Gastroenterology 1996;111:1002-1010.
86. Ruiz-del-Arbol L, Monescillo A, Arocena C, et al. Circulatory function and hepatorenal syndrome in cirrhosis. Hepatology 2005;42:439-447.
87. Longacre AV, Imaeda A, Garcia-Tsao G, Fraenkel L. A pilot project examining the predicted preferences of patients and physicians in the primary prophylaxis of variceal hemorrhage. Hepatology 2008;47:169-176.
88. Bolognesi M, Balducci G, Garcia-Tsao G, et al. Complications in the medical treatment of portal hypertension. In: de Franchis R ed. Portal Hypertension III: Proceedings of the Third Baveno International Consensus Workshop on Definitions, Methodology, and Therapeutic Strategies. Blackwell Science, Oxford; 2001, pp 180-201.
89. Merkel C, Bolognesi M, Sacerdoti D, et al. The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology 2000;32:930-934.
90. Bureau C, Péron JM, Alric L"A La Carte" treatment of portal hypertension: Adapting medical therapy to hemodynamic response for the prevention of bleeding. Hepatology 2002;36:1361-1366.
91. Thalheimer U, Mela M, Patch D, Burroughs AK. Targeting portal pressure measurements: a critical reappraisal. Hepatology 2004;39:286-290.
92. Garcia-Tsao G, Bosch J, Groszmann RJ. Portal hypertension and variceal bleeding--unresolved issues. Summary of an American Association for the study of liver diseases and European Association for the study of the liver single-topic conference. Hepatology 2008;47:1764-1772.
93. La Mura V, Abraldes JG, Raffa S, et al. Prognostic value of acute hemodynamic response to i.v. propranolol in patients with cirrhosis and portal hypertension. J Hepatol 2009;51:279-287.
94. Villanueva C, Aracil C, Colomo A, et al. Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding. Gastroenterology 2009;137:119-128.
95. Senzolo M, Cholongitas E, Marelli L, Thalheimer U, Patch D, Burroughs AK. The low incidence of bacterial infections could be a protective factor against variceal bleeding per se in hemodynamic responders to propranolol. Am J Gastroenterol 2006;101:2436-2437.
96. Triantos C, Samonakis D, Thalheimer U, Patch D, Burroughs A. The relationship between liver function and portal pressure: what comes first, the chicken or the egg? J Hepatol 2005;42:146-147.