Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis

Yang‐Te ‐T Tsai, Fa‐Yauh ‐Y Lee, Han‐Chieh ‐C Lin, Ting-Tsung Chang, Chii‐Shyan ‐S Lay, Sun‐Sang ‐S Wang, Chi‐Woon ‐W Kong, Shou‐Dong ‐D Lee, Kwang‐Juei ‐J Lo

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Abstract

We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide‐5‐mononitrate, a long‐acting organic nitrate, in 19 patients with HBsAg‐positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide‐5‐mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 ± 13 (mean ± S.D.) to 82 ± 14 mmHg, from 12.9 ± 4.5 to 9.3 ± 2.4 mmHg and from 6.9 ± 3.4 to 4.3 ± 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 ± 3.6 to 17.5 ± 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 ± 5.2 to 16.6 ± 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide‐5‐mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1‐hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1‐hr) or delayed (7‐day) studies. Three patients (30%) developed mild headache or dizziness and two patients (20%) demonstrated systolic hypotension (<80 mmHg) during the immediate study. This study shows that isosorbide‐5‐mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg‐positive cirrhosis. In addition, the isosorbide‐5‐mononitrate may affect the systemic circulation more than the portal circulation.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalHepatology
Volume10
Issue number3
DOIs
Publication statusPublished - 1989 Jan 1

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Fibrosis
Hemodynamics
Venous Pressure
Liver
Portal Pressure
Arterial Pressure
Placebo Effect
Pulmonary Wedge Pressure
Dizziness
Portal Hypertension
Vascular Resistance
Nitrates
Hypotension
Headache
Oral Administration
Heart Rate
Lung

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Tsai, YT. T., Lee, FY. Y., Lin, HC. C., Chang, T-T., Lay, CS. S., Wang, SS. S., ... Lo, KJ. J. (1989). Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis. Hepatology, 10(3), 283-287. https://doi.org/10.1002/hep.1840100305
Tsai, Yang‐Te ‐T ; Lee, Fa‐Yauh ‐Y ; Lin, Han‐Chieh ‐C ; Chang, Ting-Tsung ; Lay, Chii‐Shyan ‐S ; Wang, Sun‐Sang ‐S ; Kong, Chi‐Woon ‐W ; Lee, Shou‐Dong ‐D ; Lo, Kwang‐Juei ‐J. / Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis. In: Hepatology. 1989 ; Vol. 10, No. 3. pp. 283-287.
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abstract = "We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide‐5‐mononitrate, a long‐acting organic nitrate, in 19 patients with HBsAg‐positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide‐5‐mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 ± 13 (mean ± S.D.) to 82 ± 14 mmHg, from 12.9 ± 4.5 to 9.3 ± 2.4 mmHg and from 6.9 ± 3.4 to 4.3 ± 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 ± 3.6 to 17.5 ± 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 ± 5.2 to 16.6 ± 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide‐5‐mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1‐hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1‐hr) or delayed (7‐day) studies. Three patients (30{\%}) developed mild headache or dizziness and two patients (20{\%}) demonstrated systolic hypotension (<80 mmHg) during the immediate study. This study shows that isosorbide‐5‐mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg‐positive cirrhosis. In addition, the isosorbide‐5‐mononitrate may affect the systemic circulation more than the portal circulation.",
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Tsai, YTT, Lee, FYY, Lin, HCC, Chang, T-T, Lay, CSS, Wang, SSS, Kong, CWW, Lee, SDD & Lo, KJJ 1989, 'Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis', Hepatology, vol. 10, no. 3, pp. 283-287. https://doi.org/10.1002/hep.1840100305

Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis. / Tsai, Yang‐Te ‐T; Lee, Fa‐Yauh ‐Y; Lin, Han‐Chieh ‐C; Chang, Ting-Tsung; Lay, Chii‐Shyan ‐S; Wang, Sun‐Sang ‐S; Kong, Chi‐Woon ‐W; Lee, Shou‐Dong ‐D; Lo, Kwang‐Juei ‐J.

In: Hepatology, Vol. 10, No. 3, 01.01.1989, p. 283-287.

Research output: Contribution to journalArticle

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T1 - Lack of effects of isosorbide‐5‐mononitrate on hepatic hemodynamics in HBsAg‐positive cirrhosis

AU - Tsai, Yang‐Te ‐T

AU - Lee, Fa‐Yauh ‐Y

AU - Lin, Han‐Chieh ‐C

AU - Chang, Ting-Tsung

AU - Lay, Chii‐Shyan ‐S

AU - Wang, Sun‐Sang ‐S

AU - Kong, Chi‐Woon ‐W

AU - Lee, Shou‐Dong ‐D

AU - Lo, Kwang‐Juei ‐J

PY - 1989/1/1

Y1 - 1989/1/1

N2 - We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide‐5‐mononitrate, a long‐acting organic nitrate, in 19 patients with HBsAg‐positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide‐5‐mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 ± 13 (mean ± S.D.) to 82 ± 14 mmHg, from 12.9 ± 4.5 to 9.3 ± 2.4 mmHg and from 6.9 ± 3.4 to 4.3 ± 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 ± 3.6 to 17.5 ± 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 ± 5.2 to 16.6 ± 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide‐5‐mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1‐hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1‐hr) or delayed (7‐day) studies. Three patients (30%) developed mild headache or dizziness and two patients (20%) demonstrated systolic hypotension (<80 mmHg) during the immediate study. This study shows that isosorbide‐5‐mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg‐positive cirrhosis. In addition, the isosorbide‐5‐mononitrate may affect the systemic circulation more than the portal circulation.

AB - We conducted a randomized controlled hemodynamic study to evaluate the effect of placebo and 20 mg isosorbide‐5‐mononitrate, a long‐acting organic nitrate, in 19 patients with HBsAg‐positive cirrhosis by the simultaneous measurement of portal venous pressure and wedged hepatic venous pressure. Baseline values for the two groups were similar. One hour after oral administration of 20 mg isosorbide‐5‐mononitrate in 10 patients, mean arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure significantly decreased from 92 ± 13 (mean ± S.D.) to 82 ± 14 mmHg, from 12.9 ± 4.5 to 9.3 ± 2.4 mmHg and from 6.9 ± 3.4 to 4.3 ± 1.8 mmHg, respectively. However, both portal venous pressure gradient (from 18.1 ± 3.6 to 17.5 ± 3.0 mmHg) and hepatic venous pressure gradient (from 17.8 ± 5.2 to 16.6 ± 5.3 mmHg) remained unchanged during the study. In six patients who received 20 mg isosorbide‐5‐mononitrate twice daily for 7 days, hepatic venous pressure gradient remained unaltered as compared to basal and 1‐hr values. There was no significant change in cardiac index, heart rate or systemic vascular resistance in either immediate (1‐hr) or delayed (7‐day) studies. Three patients (30%) developed mild headache or dizziness and two patients (20%) demonstrated systolic hypotension (<80 mmHg) during the immediate study. This study shows that isosorbide‐5‐mononitrate appears to have no effect in treating portal hypertension in patients with HBsAg‐positive cirrhosis. In addition, the isosorbide‐5‐mononitrate may affect the systemic circulation more than the portal circulation.

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