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Related Experiment Videos

[Is it possible to predict a decrease in portal pressure after administration of ACE inhibitors?]

P Svoboda1, I Kantorová, J Ochmann

  • 1Urazová nemocnice Brno.

Vnitrni Lekarstvi
|March 1, 1994
PubMed
Summary
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Enalapril significantly reduces angiotensin converting enzyme (ACE) levels in patients with portal hypertension. However, this decrease does not reliably predict the drug

Area of Science:

  • Cardiology
  • Gastroenterology
  • Pharmacology

Background:

  • Portal hypertension is a serious condition often leading to esophageal varices.
  • Angiotensin converting enzyme (ACE) inhibitors like enalapril have shown potential in managing portal pressure.
  • Previous studies indicated enalapril decreases portal pressure in about half of patients with portal hypertension.

Purpose of the Study:

  • To investigate the effect of enalapril combined with sclerotherapy on portal pressure in patients with portal hypertension.
  • To assess the correlation between serum ACE levels and changes in hepatic venous pressure gradient (HVPG) after enalapril treatment.

Main Methods:

  • Twenty-one consecutive patients with a history of bleeding esophageal varices were enrolled.
  • Patients received sclerotherapy concurrently with enalapril treatment.

Related Experiment Videos

  • Serum ACE levels and HVPG were measured before and after 3 months of treatment.

    • Main Results:

    • Patients with portal hypertension exhibited significantly higher baseline ACE levels compared to normal populations.
    • Enalapril treatment effectively reduced ACE levels to normal or subnormal ranges in all patients.
    • A significant decrease in HVPG (>3 mm Hg) was observed in only 11 patients (52%), with no correlation to ACE level changes.

    Conclusions:

    • Patients with portal hypertension have elevated serum ACE levels, which are substantially reduced by enalapril.
    • Serum ACE levels cannot predict the efficacy of enalapril in reducing portal pressure in individual patients.
    • Combined therapy requires further investigation to optimize outcomes in portal hypertension management.