Relationship among Beta-Adrenergic Blockade, Propranolol Concentration, and Liver Function in Patients with Cirrhosis

Abstract

In 20 patients with cirrhosis we studied the relationship among the efficiency of β-adrenergic blockade induced by oral administration of 40 mg propranolol, the plasma level of propranolol, and the liver function. The β-adrenergic blockade was studied 2 h and 8 h after propranolol administration and assessed by the cardiac chronotropic response to isoprenaline. Liver function was evaluated by a standard liver function test and the Child-Turcotte or Pugh score. The β-adrenergic blockade and propranolol plasma concentration were higher 2 h than 8 h after propranolol administration. The β-adrenergic blockade and the propranolol plasma concentration varied widely among patients. No significant correlation was found between the efficiency of β-blockade and propranolol concentration. The β-adrenergic response before propranolol administration was correlated with bilirubin level and Child scores, but no significant correlation was found between the β-blockade and the severity of liver disease. These results suggest that in patients with cirrhosis, differences in response to propranolol are not related to differences in the severity of the liver disease or to differences in propranolol concentration.

Key Words:

• β-Adrenergic response
• cirrhosis
• isoprenaline test
• propranolol