Effect of ET?A blockade on portal pressure and hepatic arterial perfusion in patients with cirrhosis: A proof of concept study

Background/aim Endothelin causes vasoconstriction via the endothelin-A receptor (ET-A) in intrahepatic circulation cirrhosis and its increase leads to portal hypertension. The aim of study was investigate acute effect a selective ET-A antagonist patients with hypertension cirrhosis. Methods Proof-of-concept two different substudies: (a) local administration BQ 123 (b) systemic oral Ambrisentan. Portal pressure determined by hepatic venous gradient (HVPG, both substudies) arterial blood flow (HABF) intra-arterial Doppler measurements (substudy 1) before under antagonist. Systemic haemodynamic parameters were measured substudy 2. Results Twelve (Child-Pugh [CP] B/C n = 7/5) included 1 14 (CP A/B/C 4/6/4) relative decrease HVPG ?12.5% (IQR: ?40% 0%; P .05) ?5.0% ?11.5% .01) Substudy revealed higher CP B patients. HABF increased significantly without showed HABF. 2 slight mean changes other parameters. Conclusion Administration decreases cirrhotic This non-responders flow. Selective antagonists might be future treatment option