Background: Hemorragic portal hypertension (HTP-H) has a mortality of 30-40%. Propranolol alone or in combination with isosorbide-5-mononitrate (5MNI) has been wed as hemorrhage preventive treatment.
Objective: Compare propranolol vs. propranolol and 5MNI as preventive treatment of HTP-H, evaluating splachnic hemodynamics by color Doppler ultrasound (EDC).
Methodology: We included 20 patients with liver cirrhosis, mean age 53.3 years, 13 female, 10 for primary prevention and assigned them in to 2 groups treatment: l.- Propranolol alone (10 patients), ll.- Propranolol + 5-MNI (10 patients). We carried out EDC to each patient before iniciating and 2 months after treatment.
Results: A decrease in splachnic hemodynamics was found in both groups as measured by portal vein (PV), hepatic artery (HA) velocity and flux decreased in group I were: PV velocity from 15.4 to 12.5 cm/seg (p = 0.019089 ) and flux from 1639.8 to 1396.8 mL/min (p = 0.031082), HA velocity from 50.1 to 44.5 cm/seg (p = 0.120385), and flux 547.1 a 470 mL/min (p = 0.069642); in group 11: PV from 16.6 to 12.9 (p = 0.019699) and from 1,786.8 to 1,304.2 (p = 0.004072), in HA from 52.3 to 44.4 (p = 0.003498 ) and 612.5 to 448.8 (p = 0.000285).
Conclusion: Propranolol and 5-MNI decreases splachnic flux and velocity more than propranolol alone, in consequence it should be better to prevent bleeding from portal hypertension.