{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T13:11:42Z","timestamp":1773061902227,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/aim<\/jats:title><jats:p>Endothelin causes vasoconstriction via the endothelin\u2010A receptor (ET\u2010A) in the intrahepatic circulation in cirrhosis and its increase leads to portal hypertension. The aim of the study was to investigate the acute effect of a selective ET\u2010A antagonist in patients with portal hypertension and cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Proof\u2010of\u2010concept study with two different substudies: (a) local intrahepatic administration of the ET\u2010A antagonist BQ 123 and (b) systemic oral administration of the ET\u2010A antagonist Ambrisentan. Portal pressure was determined by hepatic venous pressure gradient (HVPG, both substudies) and hepatic arterial blood flow (HABF) by intra\u2010arterial Doppler measurements (substudy 1) before and under the ET\u2010A antagonist. Systemic haemodynamic parameters were measured in substudy 2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve patients (Child\u2010Pugh [CP] B\/C n\u00a0=\u00a07\/5) were included in substudy 1 and 14 patients (CP A\/B\/C n\u00a0=\u00a04\/6\/4) in substudy 2. The relative decrease in HVPG was \u221212.5% (IQR: \u221240% to 0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05) in substudy 1 and \u22125.0% (IQR: \u221211.5% to 0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) in substudy 2. Substudy 1 revealed higher decrease in HVPG in CP B patients. HABF increased significantly and patients without portal pressure decrease showed a higher increase of HABF. Substudy 2 showed a slight decrease in the mean arterial pressure without changes of other systemic haemodynamic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Administration of a selective ET\u2010A antagonist decreases the portal pressure in cirrhotic patients. This decrease was higher in CP B patients and the non\u2010responders showed a higher increase in hepatic arterial flow. Selective ET\u2010A antagonists might be a future treatment option in patients with portal hypertension.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14757","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T05:55:44Z","timestamp":1607579744000},"page":"554-561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effect of ET\u2010A blockade on portal pressure and hepatic arterial perfusion in patients with cirrhosis: A proof of concept study"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8403-7983","authenticated-orcid":false,"given":"Alexander","family":"Zipprich","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine Martin\u2010Luther\u2010University Halle\u2010Wittenberg Halle (Saale) 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