Non selective beta blockers in cirrhosis

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Beta-blockers in liver cirrhosis

Since the original description of the effectiveness of β-blockers in lowering the portal pressure and therefore the risk of variceal bleeding, more than 500 articles in the English literature on the use of non selective β-blockers (NSBB) in cirrhosis have been published. The use of NSBB in pre-primary prophylaxis of variceal bleeding is currently not indicated. In primary prophylaxis, patients ...

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Nonselective Beta-blockers in Patients with Cirrhosis: "the Therapeutic Window".

For over 30 years, nonselective beta-blockers (NSBB) have been successfully used for preventing variceal bleeding in patients with cirrhosis and portal hypertension. Nevertheless, recent studies suggest that NSBB may be effective only within a particular "therapeutic window" in patients with advanced liver disease. Outside of this window, in early stages of cirrhosis and in very advanced cirrho...

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Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis.

BACKGROUND Nonselective beta-adrenergic blockers decrease portal pressure and prevent variceal hemorrhage. Their effectiveness in preventing varices is unknown. METHODS We randomly assigned 213 patients with cirrhosis and portal hypertension (minimal hepatic venous pressure gradient [HVPG] of 6 mm Hg) to receive timolol, a nonselective beta-blocker (108 patients), or placebo (105 patients). T...

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Is the use of non-selective beta-blockers necessary in cirrhotic patients with small varices?

Non-selective β-blockers (NSBBs) could eff ectively prevent the development of fi rst variceal bleeding in cirrhotic patients with medium/large varices. However, as recently reviewed by Giannelli et al [1], the clinical benefi t of NSBBs remains controversial in cirrhotic patients with small varices. In line with their considerations, we would like to further comment on the controversy. A previ...

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Can hypersplenism secondary to portal hypertension be treated by non-selective beta blockers?

Hypersplenism in chronic liver diseases (CLD) is characterized by splenomegaly and thrombocytopenia. Thrombocytopenia is a contraindication to percutaneous liver biopsy, which is an important procedure for diagnostic work-up of liver disease. In children, the etiologies of CLD are more diverse than in adults, and include congenital, metabolic and infiltrative diseases as well as viral hepatitis...

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ژورنال

عنوان ژورنال: Journal of Hepatology

سال: 2017

ISSN: 0168-8278

DOI: 10.1016/j.jhep.2017.05.031