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PORTAL HYPERTENSION TREATMENT WITH CANDESARTAN PLUS PROPRANOLOL FOR NINE MONTHS RESTORES NORMAL PORTAL CIRCULATION HEMODYNAMIC PATTERN

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Last updated: 25 Dec 2024

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Abstract

Post HCV liver cirrhosis is one of the most prominent etiologies behind the abnormal portal circulation hemodynamics. It occurs as a result of distorted balance between portal venous flow (PVF) and intrahepatic resistances (IHR). PVF is partially controlled by using both specific and non-specific beta blockers (NSBBs) that have insignificant effects on IHR. Angiotensin receptor blockers (ARBs) inhibit the activated hepatic stellate cell (HSC) contraction and thought to reduce the dynamic portion of IHR. The study aimed to slow down the venous blood flow and to reduce the IHR of portal vein vasculature to control sequelae of the enhanced post cirrhosis portal venous turbulence. We evaluated the effects of Candesartan plus propranolol compared to each of them individually in management of portal hypertension (PH). Three groups of 25 patients each, presented with chronic HCV infection and grade II- III esophageal varices (OV), were randomly assigned to one of three treatment regimens: Propranolol or Candesartan or both. Subjects were screened every three month by Doppler Ultrasound for a total of nine months. Damping Index (DI), pulse Pulsatility Index (PI), Portal Venous Flow (PVF) Volume, Portal Venous Peak Velocity (PVPV), and Portal Vein Diameter (PVD) were evaluated once every third month. Our study concluded that combined therapy (Propranolol + Candesartan) induced highly significant improvements that led to restoration of normal values of DI, PI, PVF volume & PVPV overtime compared to monotherapy regimens (P>0.001). Data strongly recommended using Propranolol plus Candesartan in overtime management of portal hypertension.

DOI

10.21608/jesp.2016.88263

Keywords

Portal-vein, hemodynamics, NSBBs, ARBs, Combined therapy

Authors

First Name

MOHAMED

Last Name

ABD ALLA

MiddleName

D.

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Egypt

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First Name

EL-SAYED

Last Name

EID

MiddleName

M. M.

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Egypt

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-

Orcid

-

First Name

ALI

Last Name

SOLIMAN

MiddleName

I. A.

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Egypt

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-

Orcid

-

First Name

MOSTAFA

Last Name

ELHAWARY

MiddleName

A.

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Egypt

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-

City

-

Orcid

-

First Name

YASSER

Last Name

KILANY

MiddleName

F.

Affiliation

Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Egypt

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-

Orcid

-

First Name

GADAH

Last Name

ABD-ALMONAEM

MiddleName

-

Affiliation

Department of Radiology, Faculty of Medicine, Al-Zagazig University, Egypt

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-

Orcid

-

First Name

SAMEH

Last Name

BAYOUMI

MiddleName

S.

Affiliation

Department of Radiology, Faculty of Medicine, Al-Zagazig University, Egypt.

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-

Orcid

-

First Name

MOHAMED

Last Name

MOURSY

MiddleName

R. A.

Affiliation

Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt

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-

City

-

Orcid

-

First Name

FARES

Last Name

AL-ZAEM

MiddleName

A. M.

Affiliation

Department of Medicine, Hepatology ICU Division, Hhia Central Hospital

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-

City

-

Orcid

-

Volume

46

Article Issue

3

Related Issue

11654

Issue Date

2016-12-01

Receive Date

2020-05-10

Publish Date

2016-12-01

Page Start

587

Page End

604

Print ISSN

1110-0583

Online ISSN

2090-2549

Link

https://jesp.journals.ekb.eg/article_88263.html

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https://jesp.journals.ekb.eg/service?article_code=88263

Order

16

Type

Original Article

Type Code

1,127

Publication Type

Journal

Publication Title

Journal of the Egyptian Society of Parasitology

Publication Link

https://jesp.journals.ekb.eg/

MainTitle

PORTAL HYPERTENSION TREATMENT WITH CANDESARTAN PLUS PROPRANOLOL FOR NINE MONTHS RESTORES NORMAL PORTAL CIRCULATION HEMODYNAMIC PATTERN

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Article

Created At

22 Jan 2023