Effect of Betablocker or Aldosterone Antagonist Therapy on Patients With Liver Cirrhosis

Effect of Betablocker or Aldosterone Antagonist Therapy on Oxygenation, Peripheral and Cardiac Hemodynamics and Humoral Systems

The study´s purpose is to investigate the effect of beta blockade or aldosterone antagonist therapy on oxygenation, peripheral and cardiac hemodynamics and humoral systems, in patients with liver cirrhosis.

Cardio-pulmonal complications to patients with liver cirrhosis and portal hypertension determine the patients' prognosis. Most patients have hemodynamical changes in circulation with increased cardiac output and decreased systolic function in stress. Endothelial dysfunction is a parameter for bad prognosis in cardiovascular disease. The Renin-angiotensin-aldosterone-system plays an important role in natrium and volume regulation. Descriptions of changes in the peripheral circulation and oxygenation have been deficient up to now.

Patients with liver cirrhosis and portal hypertension are betablockers and/or aldosterone antagonists routine treatment - effects on peripheral hemodynamics and oxygenation in relation to central hemodynamic changes are deficient.

Inclusion Criteria:

• Liver cirrhosis
• Clinical indication for treatment with betablocker or aldosterone antagonist
• Must not have been treated earlier with betablocker or aldosterone antagonist
• Must have been alcohol abstinent for more than 4 weeks

Exclusion Criteria:

• Gastrointestinal bleeding in the last 2 weeks
• Encephalopathy > grade 1
• Acute medical conditions
• Malignant disease
• Pregnancy