ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Oral Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress2010/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Oral Presentations</h1> <P><b>Session Title:</b> Parallel Session: LIVER CIRRHOSIS AND COMPLICATIONS<br><b>Presentation Date:</b> Apr 15, 2010</P><h2 align='left'><B>DARK CHOCOLATE ATTENUATES THE POST-PRANDIAL INCREASE IN HVPG IN PATIENTS WITH CIRRHOSIS AND PORTAL HYPERTENSION </B></h2> <p align='left'><b>A. De Gottardi</b><sup>1,2</sup>, A. Berzigotti<sup>1</sup>, S. Seijo<sup>1</sup>, M. D'Amico<sup>1</sup>, J. Abraldes<sup>1</sup>, J.C. Garcia-Pagán<sup>1</sup>, J. Bosch<sup>1</sup><br> <em><sup>1</sup>Hemodynamic Laboratory, Liver Unit and Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Barcelona, Spain, <sup>2</sup>University Clinic of Visceral Surgery and Medicine, Inselspital, Bern, Switzerland, <sup>3</sup>Centre de Diagnostic per l'Imatge, Hospital Clinic de Barcelona, <sup>4</sup>Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University of Barcelona, Barcelona, Spain. *andrea.degottardi@ikp.unibe.ch</em></p><br> <p align='justify'><b>Background and aim: </b>Dark chocolate holds verified potent antioxidant properties mediated by its high content in cocoa flavonoids. In cirrhosis, the intrahepatic circulation exhibits endothelial dysfunction which is promoted among others by oxidative stress and reduced antioxidant systems. Intrahepatic endothelial dysfunction has been studied in patients by evaluating the post-prandial increase in hepatic venous pressure gradient (HVPG). We hypothesized that dark chocolate might improve intrahepatic endothelial dysfunction in cirrhosis, and designed this study to evaluate whether this nutrient may attenuate the postprandial increase of HVPG in portal hypertensive cirrhotic patients. <br><b><b>Patients and methods: </b></b> Twenty-one cirrhotic patients with esophageal varices (Child score 6.9±1.8; MELD 11±4; HVPG 16.6±3.8 mmHg) were randomized to receive a standard liquid meal containing either dark chocolate (active treatment, containing 85% cocoa, 0.55 g of dark chocolate/Kg of body weight; n=10) or white chocolate (devoid of cocoa flavonoids; control, n=11) in a iso-caloric composition according to the body weight. HVPG, arterial pressure and portal blood flow (PBF) by US-Doppler were measured at baseline and 30 minutes after meal administration. <br><b>Results: </b> Both test meals caused a highly significant but similar increase in portal blood flow (median increase in PBF: +24% in dark chocolate Vs +34% in white chocolate, NS). Post-prandial hyperemia was accompanied by an increase in HVPG: dark chocolate from 17.3±3.6 mmHg to 19.1±2.6 mmHg (p=0.07); white chocolate from 16.0±4.7 mmHg to 19.7±4.1 mmHg (p=0.003). The post-prandial increase in HVPG was markedly attenuated in patients receiving dark chocolate (+10.3±16.3% Vs +26.3±12.7%, p=0.02). Moreover, dark chocolate patients, but not white chocolate ones, showed a significant post-prandial increase in mean arterial pressure (+9.9±8.4% vs. -0.3±4.9%, p=0.003). <br><b>Conclusions: </b> In patients with cirrhosis a test meal containing dark chocolate blunted the post-prandial increase in HVPG without changing post-prandial hyperemia, suggesting that it acted by attenuating hepatic endothelial dysfunction so allowing intrahepatic vasorelaxation in response to the post-prandial increase in portal blood flow. Dark chocolate also increased mean arterial pressure, indicating that it also exerted beneficial systemic effects. This study suggests that adding dark chocolate to meals may attenuate the brisk post-prandial increase in portal pressure observed in portal hypertensive cirrhotic patients. <br></p> <br><a href="javascript://;" onclick="history.back()">Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>