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[Physiopathologic basis of medical therapy of portal hypertension in cirrhosis].
Ann Ital Med Int. 1996 Oct; 11 Suppl 2:39S-47S.AI

Abstract

The in-depth study of the pathophysiology of portal hypertension is the basis for a correct medical treatment. The backward-flow theory of portal hypertension stresses the importance of increased hepatic vascular resistance, while the forward-flow theory of portal hypertension underscores generalized vasodilation, the hyperdynamic circulation and increased portal inflow. The role of expanded plasma volume has been emphasized in recent studies. The aim of drug therapy is to normalize each one of these components. Vasoconstrictor agents, i.e. vasopressin, triglycyl-lysin-vasopressin, non selective beta-blockers, somatostatin and octreotide, try to normalize the increased portal inflow and to decrease porto-collateral blood flow. Venous vasodilators, e.g. nitrates, mainly act by decreasing portal blood outflow resistance. Spironolactone has been proposed to decrease plasma volume. The use of a combination of a vasoconstrictor agent and a vasodilator or spironolactone has been proposed to increase the efficacy of medical treatment.

Authors+Show Affiliations

Gatta A
Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Padova.
Bolognesi M
No affiliation info available
Sacerdoti D
No affiliation info available
Merkel C
No affiliation info available

MeSH

HumansHypertension, PortalLiver CirrhosisSplanchnic CirculationVasoconstrictor AgentsVasodilator Agents

Pub Type(s)

English Abstract
Journal Article
Review

Language

ita

PubMed ID

9004819

Citation

Gatta, A, et al. "[Physiopathologic Basis of Medical Therapy of Portal Hypertension in Cirrhosis]." Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, vol. 11 Suppl 2, 1996, 39S-47S.
Gatta A, Bolognesi M, Sacerdoti D, et al. [Physiopathologic basis of medical therapy of portal hypertension in cirrhosis]. Ann Ital Med Int. 1996;11 Suppl 2:39S-47S.
Gatta, A., Bolognesi, M., Sacerdoti, D., & Merkel, C. (1996). [Physiopathologic basis of medical therapy of portal hypertension in cirrhosis]. Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, 11 Suppl 2, 39S-47S.
Gatta A, et al. [Physiopathologic Basis of Medical Therapy of Portal Hypertension in Cirrhosis]. Ann Ital Med Int. 1996;11 Suppl 2:39S-47S. PubMed PMID: 9004819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Physiopathologic basis of medical therapy of portal hypertension in cirrhosis]. AU - Gatta,A, AU - Bolognesi,M, AU - Sacerdoti,D, AU - Merkel,C, PY - 1996/10/1/pubmed PY - 1996/10/1/medline PY - 1996/10/1/entrez SP - 39S EP - 47S JF - Annali italiani di medicina interna : organo ufficiale della Societa italiana di medicina interna JO - Ann Ital Med Int VL - 11 Suppl 2 N2 - The in-depth study of the pathophysiology of portal hypertension is the basis for a correct medical treatment. The backward-flow theory of portal hypertension stresses the importance of increased hepatic vascular resistance, while the forward-flow theory of portal hypertension underscores generalized vasodilation, the hyperdynamic circulation and increased portal inflow. The role of expanded plasma volume has been emphasized in recent studies. The aim of drug therapy is to normalize each one of these components. Vasoconstrictor agents, i.e. vasopressin, triglycyl-lysin-vasopressin, non selective beta-blockers, somatostatin and octreotide, try to normalize the increased portal inflow and to decrease porto-collateral blood flow. Venous vasodilators, e.g. nitrates, mainly act by decreasing portal blood outflow resistance. Spironolactone has been proposed to decrease plasma volume. The use of a combination of a vasoconstrictor agent and a vasodilator or spironolactone has been proposed to increase the efficacy of medical treatment. SN - 0393-9340 UR - https://www.unboundmedicine.com/medline/citation/9004819/[Physiopathologic_basis_of_medical_therapy_of_portal_hypertension_in_cirrhosis]_ DB - PRIME DP - Unbound Medicine ER -