Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up.

Deibert, Peter; Lazaro, Adhara; Stankovic, Zoran; Schaffner, Denise; Rössle, Martin; Kreisel, Wolfgang (2018). Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up. World journal of gastroenterology, 24(3), pp. 438-444. WJG Press 10.3748/wjg.v24.i3.438

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Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Stankovic, Zoran

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1007-9327

Publisher:

WJG Press

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

23 Apr 2018 09:19

Last Modified:

23 Oct 2019 07:03

Publisher DOI:

10.3748/wjg.v24.i3.438

PubMed ID:

29391766

Uncontrolled Keywords:

Doppler sonography Liver cirrhosis Liver hemodynamics Magnetic resonance imaging Phosphodiesterase-5 Portal hypertension

BORIS DOI:

10.7892/boris.113299

URI:

https://boris.unibe.ch/id/eprint/113299

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