{"id":87305,"date":"2018-03-10T00:12:04","date_gmt":"2018-03-10T00:12:04","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/efectos-de-la-administracion-aguda-de-carvedilol-sobre-la-hemodinamica-sistemica-y-esplacnica-en-pacientes-con-cirrosis-hepatica-e-hipertension-portal\/"},"modified":"2018-03-10T00:12:04","modified_gmt":"2018-03-10T00:12:04","slug":"efectos-de-la-administracion-aguda-de-carvedilol-sobre-la-hemodinamica-sistemica-y-esplacnica-en-pacientes-con-cirrosis-hepatica-e-hipertension-portal","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/efectos-de-la-administracion-aguda-de-carvedilol-sobre-la-hemodinamica-sistemica-y-esplacnica-en-pacientes-con-cirrosis-hepatica-e-hipertension-portal\/","title":{"rendered":"Efectos de la administracion aguda de carvedilol sobre la hemodinamica sistemica y esplacnica en pacientes con cirrosis hepatica e hipertensi\u00f3n portal"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Belen Piqueras Alcol <\/strong><\/h2>\n<p>El s\u00edndrome de hipertensi\u00f3n portal se define por un aumento del gradiente de presi\u00f3n entre la vena porta y la vena cava inferiro. La hemorragia por varices esofagog\u00e1stricas es la complicaci\u00f3n m\u00e1s grave de dicho s\u00edndrome. par conseguir protecci\u00f3n efectiva contra el riesgo de hemorragia, la presei\u00f3n portal, habitualmente media como el gradiente de presi\u00f3n venosa hep\u00e1tico (gpvh), debe disminuir a -de 12 mmhg o al menos un 20% del valor basal. el rporanolol es el f\u00e1rmaco acutalmente aceptado para la profilaxis de la hemorragia por varices, sin embargo su efecto es heterog\u00e9neo, existiendo un 30% de no respondedores.  se han buscado alternativas con f\u00e1rmacos vasodilatadores, como el 5-mis,y con terapia combianada para lograr un mayor descenso de la presi\u00f3n portal. el objetivo de este estudio fue investiagr si el carvedilol, un betabloqueante no selectivo con actividad vasodilatadora anti-a1-adren\u00e9rgica puede originar un descenso del gpvh superiro al propanolol. Para ello se compar\u00f3 el efecto agudo de carvedilol, propranololy placebo en la hemodin\u00e1mica sist\u00e9matica y espl\u00e1cica en 35 pacientes cirr\u00f3ticos con hipertensi\u00f3n portal.  el carvedilol redujo marcadamente el gpvh (19,5+1,3 a 15,4+ 1 mmhg, p-0,001), siendo este descenso significativamente superior al obtenido con propranolol (-20,4+2 vs -12,7+2%, p0,05).  adem\u00e1s, el carvedilol redujo la presi\u00f3nportal por debajo de 12 mmhg o a menos de un 20% del basal en un porcentaje  significativamente superior de pacientes (64% vs 14%, p 0,05). Ambos f\u00e1rmacos indujeron similar descenso en el flujo sangu\u00edneo hep\u00e1tico y en el flujo de la \u00e1cigos.  el descenso del gasto cardiaco y de la frecuencia cardiaca fue significativamente supeior conpropranolol, mientras el carvedilol indujo un mayor descenso en la tam (-23,1 vs 11%, p- 0,05). En conclusi\u00f3n, los resultados de esta tesis muestran que en pacientes con cirroisis hep\u00e1tica la administraci\u00f3n aguda de carvedilol presenta un<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Efectos de la administracion aguda de carvedilol sobre la hemodinamica sistemica y esplacnica en pacientes con cirrosis hepatica e hipertensi\u00f3n portal<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Efectos de la administracion aguda de carvedilol sobre la hemodinamica sistemica y esplacnica en pacientes con cirrosis hepatica e hipertensi\u00f3n portal <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Belen Piqueras Alcol <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Complutense de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 13\/11\/2000<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Rafael Ba\u00f1ares Ca\u00f1izares<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: manuel Diaz rubio garcia <\/li>\n<li>ricardo Moreno otero (vocal)<\/li>\n<li>agust\u00edn Albillos mart\u00ednez (vocal)<\/li>\n<li>valent\u00edn Cuervas-mons mart\u00ednez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Belen Piqueras Alcol El s\u00edndrome de hipertensi\u00f3n portal se define por un aumento del gradiente de presi\u00f3n [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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