Effect of Propranolol on Portal Vein Hemodynamics: Assessment by Duplex Sonography and Indocyanine Green Clearance in Healthy Volunteers

In the past decade several randomized trials have shown a beneficial effect of propranolol in cirrhotic patients. The effect of propranolol has been attributed to a reduction in portal vein pressure. So far the monitoring of portal vein hemodynamics following propranolol administration has been achieved mainly by hepatic vein catheterization. We studied the effect of propranolol on portal vein hemodynamics noninvasively in five healthy volunteers using duplex sonography and indocyanine green clearance. Measured by duplex sonography, blood flow was reduced by 28.6% in the portal vein (P < 0.05) and by 8.7% in the hepatic artery (NS) 60 min after oral administration of 80 mg propranolol. During this time total hepatic blood flow, measured by indocyanine green clearance, was reduced by 19.5% (P < 0.05). We conclude that both methods are useful for the study of portal vein hemodynamics during propranolol therapy, duplex sonography being more easily practicable.