Does Atorvastatin has Adding Effect to Propranolol in Control of Portal Hemodynamics in Patients with Liver Cirrhosis

Abstract

Background and study aim: Portal hypertension is abnormal increase in portal pressure. Vasoreactivity, vascular ‎remodeling, and hepatic fibrosis contribute to increased intrahepatic resistance. β ‎blockers decrease cardiac output and mediate splanchnic vasoconstriction. Statins have ‎antioxidant, antiproliferative, and anti-inflammatory properties. We aimed to assess ‎portal vein pressure using Doppler ultrasound in cirrhotic patients before and after ‎atorvastatin administration‎.‎ Patients and Methods: ‎‎‎ This study was conducted on 58 patients Randomized controlled study was done at the hepatology gastroenterology and ‎infectious diseases department of Kafrelsheikh University Hospital on 40 cirrhotic ‎patients who were randomly assigned to either: Group A: included 20 cirrhotic patients ‎who were administered 20 mg of atorvastatin and 40 mg of propranolol daily for two ‎months (n=20) or Group B: patients who received 40 mg of propranolol alone daily ‎for two months (n=20). Clinical and laboratory evaluation, abdominal Doppler ‎ultrasound and upper endoscopy was done at the start and after two months‎.‎ Results: There was a significant difference in portal vein diameter before and after treatment (P-‎value = .039). Portal vein velocity, portal vein flow volume, hepatic artery resistance ‎index, and hepatic artery pulsatility index showed significant difference between both ‎groups. There was a significant difference in endoscopic grading before and after ‎treatment (P value = .000)‎‎‎‎. Conclusion: For lowering portal hypertension, atorvastatin and propranolol is more effective than ‎propranolol alone‎ ‎‎‎‎‎‎‎‎.