Phosphodiesterase-5 inhibitors decrease collateral blood flow in patients with portal hypertension

Aims: In an experimental study we showed that phosphodiesterase-5 (PDE-5) inhibitors increase portal venous, hepatic arterial and hepatic parenchymal blood flow. Clinical data published by our group demonstrated that PDE-5 inhibitors increase portal venous flow in healthy and cirrhotic human liver and lower portal pressure in cirrhotics. However, case reports suggest that the use of PDE-5 inhibitors may be a risk for variceal bleeding in liver cirrhosis. Methods: Using Doppler ultrasonography we measured systemic and hepatic hemodynamic parameters in 6 patients with liver cirrhosis and blood flow in porto-system…