Propranolol reduces variceal pressure and wall tension in schistosomiasis presinusoidal portal hypertension

Abstract

Background and Aim: Although prophylaxis with β-blockers has been shown to decrease variceal pressure and wall tension in cirrhotic patients, this has not been demonstrated in non-cirrhotic portal hypertension caused by Schistosoma mansoni infection. Methods: Thirteen patients without history of previous gastrointestinal bleeding were included. All of them had high-risk esophageal varices at endoscopy. An endoscopic gauge and a high-frequency endoscopic ultrasonography miniprobe were used to assess transmural variceal pressure and wall tension before and after achieving β-blockade with propranolol. Results: Baseline variceal pressure decreased from 13.3 ± 3.5 to 8.2 ± 2.0 mmHg (P < 0.0001) and wall tension from 500.2 ± 279.8 to 274.0 ± 108.3 mg.mm-1. The overall effect of propranolol on decreasing variceal pressure and wall tension expressed in percentage change in relation to baseline values was 35.7 ± 18.4% and 35.9 ± 26.7%, respectively (P = 0.9993). Conclusion: Propranolol significantly reduced variceal pressure and wall tension in schistosomiasis. © 2009 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.