Systemic and hepatic hemodynamics in hepatosplenic Manson's schistosomiasis with and without propranolol

• Published in: Digestive diseases and sciences Vol. 42; no. 4; pp. 751 - 761
• Main Authors: MIES, S, BRAGHIROLLI, O. NETO, BEER, A. JR, BAIA, C. E. S, ALFIERI, F. JR, PEREIRA, L. M. M. B, SETTE, M. J. A, RAIA, S
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.04.1997; Springer Nature B.V
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Biological and medical sciences; Blood Flow Velocity - drug effects; Diseases caused by trematodes; Esophageal and Gastric Varices - etiology; Esophageal and Gastric Varices - therapy; Helminthic diseases; Hemodynamics - drug effects; Humans; Hypertension, Portal - drug therapy; Hypertension, Portal - etiology; Hypertension, Portal - physiopathology; Infectious diseases; Liver Circulation - drug effects; Liver Diseases, Parasitic - complications; Liver Diseases, Parasitic - physiopathology; Male; Medical sciences; Middle Aged; Parasitic diseases; Portal Pressure - drug effects; Propranolol - therapeutic use; Prospective Studies; Schistosomiases; Schistosomiasis mansoni - complications; Schistosomiasis mansoni - physiopathology; Sclerotherapy; Spleen - blood supply; Splenic Diseases - complications; Splenic Diseases - physiopathology; Human; Spleen; Schistosoma mansoni; Liver; Splenic disease; Trematode disease; Plathelmintha; Hepatic disease; Systemic; Parasitosis; Helminthiasis; Trematoda; Result; Infection; Schistosomiasis; Chemotherapy; Helmintha; Digestive diseases; Clinical investigation; Circulatory system; Biological effect; Hemodynamics; Invertebrata; Beta blocking agent
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/A:1018803911915

Systemic and hepatic hemodynamics were prospectively studied in 11 patients with Manson's schistosomiasis and portal hypertension, as well as alterations resulting from the use of propranolol. It was decided that patients whose portal pressure was reduced by 30% with the use of the drug would not undergo surgery and that treatment would consist of the chronic use of propranolol, associated with sclerosis of esophageal varices. This objective was not met by any of the patients whose portal pressure was measured and the study was interrupted. Results show that patients with Manson's schistosomiasis and portal hypertension have hyperdynamic circulation, mild pulmonary hypertension, greatly increased splenic blood flow, and preservation of total hepatic blood flow. Administration of propranolol corrects hyperdynamic circulation, aggravates pulmonary hypertension, does not alter portal pressure and reduces the sectorial portal blood flows, especially of the azygos vein, with maintenance of total hepatic blood flow. These data favor the hypothesis of portal overflow in the physiopathology of portal hypertension of schistosomiasis.