《Table 1 Non-selective beta-blockers“window therapy”hypothesis-studies analyses》

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《Diuretic window hypothesis in cirrhosis: Changing the point of view》

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BUN:Blood urea nitrogen；CI:Cardiac index；CO:Cardiac output；HR:Hazard ratio；HRS:Hepatorenal syndrome；NSBB:Non-selective beta-blockers；PICD:Paracentesis-induced circulatory dysfunction；SBP:Spontaneous bacterial peritonitis.

Recent studies correlated changes in cardiac function as detrimental in systemic hemodynamics，leading to poor prognosis in cirrhosis[3-5].Therefore，non-selective beta-blockers（NSBB）have been suggested to have probable deleterious effects in endstage cirrhosis.Krag et al[6]suggested the existence of a“therapeutic window”for the use of NSBB in cirrhosis.They postulated that NSBB treatment in end-stage cirrhosis promotes an important decrease in cardiac index（CI），reducing the cardiac compensatory reserve to maintain blood pressure，compromising organ perfusion.It should be emphasized，however，that studies supporting the“window hypothesis”did not explore a possible and important bias in results，the diuretic effect in hemodynamics（Table 1）.