{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:42:09Z","timestamp":1790073729465,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016254","name":"Michigan State University Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016254","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nonselective beta\u2010blockers, such as propranolol and carvedilol, are used to prevent first decompensation in patients with clinically significant portal hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a systematic literature search of English language articles from inception in PubMed, Medline, and Cochrane databases to compare the effect of carvedilol and propranolol on systemic and splanchnic hemodynamics. Mean differences were pooled using a random\u2010effect model, and a\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value of &lt;\u20090.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven RCTs with a total of 351 patients were involved in the final analysis. Reduction in hepatic venous pressure gradient was significantly greater in the carvedilol group (MD\u2009=\u2009\u22120.76, 95% CI\u2009=\u2009\u22121.45 to \u22120.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Decrease in systemic vascular resistance and mean arterial pressure was significantly greater in the carvedilol group ([MD\u2009=\u2009\u2212190.55, 95% CI\u2009=\u2009\u2212307.5 to \u221273.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001] and [MD\u2009=\u2009\u22123.65, 95% CI\u2009=\u2009\u22125.94 to \u22121.36;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002], respectively). Decrease in cardiac output was greater in the propranolol group (MD\u2009=\u20090.92, 95% CI\u2009=\u20090.45\u20131.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Decrease in hepatic blood flow and right atrial pressure appeared to be greater in the propranolol group; however, this did not reach statistical significance ([MD\u2009=\u20090.13, 95% CI\u2009=\u2009\u22120.06 to 0.32;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17] and [MD\u2009=\u20090.28, 95% CI\u2009=\u2009\u22120.27 to 0.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.32], respectively). Decrease in mean pulmonary arterial pressure appeared to be greater in the carvedilol group; however, this was not statistically significant (MD\u2009=\u2009\u22120.75, 95% CI\u2009=\u2009\u22121.60 to 0.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08). There was no difference in incidence of rebleeding, shortness of breath, hepatic encephalopathy, and hypotension between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Carvedilol demonstrated a significantly greater reduction in HVPG, SVR, and MAP compared to propranolol, with no significant difference in adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.16999","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T09:15:28Z","timestamp":1747646128000},"page":"1409-1418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of Carvedilol to Propranolol in Reduction of Hepatic Venous Pressure Gradient in Liver Cirrhosis: A Meta\u2010Analysis"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3318-0127","authenticated-orcid":false,"given":"Amey","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Sparrow Hospital\u2014Michigan State University  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa\u00a0Arshad\u00a0Azam","family":"Raja","sequence":"additional","affiliation":[{"name":"Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poulami","family":"Roy","sequence":"additional","affiliation":[{"name":"North Bengal Medical College and Hospital  Siliguri West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fakhar","family":"Latif","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences  Karachi Sindh Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul\u00a0George","family":"Reji","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research  Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Novonil","family":"Deb","sequence":"additional","affiliation":[{"name":"North Bengal Medical College and Hospital  Siliguri West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan\u00a0K.","family":"Mui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sparrow Hospital\u2014University of Michigan  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Shady","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sparrow Hospital\u2014University of Michigan  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15559"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.05.024"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210061"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(03)12778\u2010X"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)32023-X"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe058208"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495\u2010198900372\u201000013"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300124"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.36947"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20101746.2002.02674.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2012.666673"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.10.013"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.327"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072\u2010016\u20109765\u2010y"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1479"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-309262"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253\u20107613.186206"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2019.07.011"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12634"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(95)91740\u20103"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2014.20.1.6"},{"key":"e_1_2_10_23_1","volume-title":"StatPearls [Internet]","author":"Delong C.","year":"2024"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(88)90441-6"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2019.12.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/1817\u20101737.58953"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i6.837"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.180570"},{"issue":"1","key":"e_1_2_10_29_1","first-page":"123","article-title":"The Hyperdynamic Circulation of Chronic Liver Diseases: From the Patient to the Molecule","volume":"45","author":"Iwakiri Y.","year":"2007","journal-title":"Hepatology"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T18:32:02Z","timestamp":1749061922000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.16999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/jgh.16999"],"URL":"https:\/\/doi.org\/10.1111\/jgh.16999","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]},"assertion":[{"value":"2024-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}