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Hepatic venous pressure gradient

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https://www.readbyqxmd.com/read/29236785/the-soluble-mannose-receptor-smr-is-elevated-in-alcoholic-liver-disease-and-associated-with-disease-severity-portal-hypertension-and-mortality-in-cirrhosis-patients
#1
Thomas Damgaard Sandahl, Sidsel Hyldgaard Støy, Tea Lund Laursen, Sidsel Rødgaard-Hansen, Holger Jon Møller, Søren Møller, Hendrik Vilstrup, Henning Grønbæk
BACKGROUND AND AIMS: Hepatic macrophages (Kupffer cells) are involved in the immunopathology of alcoholic liver disease (ALD). The mannose receptor (MR, CD206), expressed primarily by macrophages, mediates endocytosis, antigen presentation and T-cell activation. A soluble form, sMR, has recently been identified in humans. We aimed to study plasma sMR levels and its correlation with disease severity and survival in ALD patients. METHODS: We included 50 patients with alcoholic hepatitis (AH), 68 alcoholic cirrhosis (AC) patients (Child-Pugh A (23), B (24), C (21)), and 21 healthy controls (HC)...
2017: PloS One
https://www.readbyqxmd.com/read/29223365/performance-of-spleen-stiffness-measurement-in-prediction-of-clinical-significant-portal-hypertension-a-meta-analysis
#2
Jinzhen Song, Jianbo Huang, He Huang, Shiyu Liu, Yan Luo
AIM: Our purpose was to evaluate the correlation between spleen stiffness (SS) measured by ultrasound-based elastography and hepatic venous pressure gradient (HVPG) and assess the accuracy of SS in detecting clinical significant portal hypertension (CSPH) and severe portal hypertension. METHOD: Nine studies were included from thorough literature research and selection processes. A random model was used to analyze the correlation between HVPG and SS. We adopted the bivariate mixed effects model to assess the diagnostic performance...
December 6, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29210030/pharmacologic-prevention-of-variceal-bleeding-and-rebleeding
#3
REVIEW
Anna Baiges, Virginia Hernández-Gea, Jaime Bosch
BACKGROUND: Variceal bleeding is a major complication of portal hypertension, which is associated with significant mortality. Moreover, patients surviving a variceal bleeding episode have very high risk of rebleeding, which is associated with mortality as high as that of the first bleed. Because of this, prevention of bleeding from gastroesophageal varices has been one of the main therapeutic goals since the advent of the first effective therapies for portal hypertension. AIM: This review deals with the present day state-of-the-art pharmacological prevention of variceal bleeding in primary and secondary prophylaxis...
December 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/29201796/hepatic-venous-pressure-gradient-measurement-in-bangladeshi-cirrhotic-patients-a-correlation-with-child-s-status-variceal-size-and-bleeding
#4
Mamun Al Mahtab, Sheikh M Noor E Alam, Mohammad A Rahim, Mohammad A Alam, Faiz A Khondaker, Ahmed L Moben, Masuda Mohsena, Sheikh Mohammad Fazle Akbar
Background: Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child-Pugh status, and variceal bleeding. Materials and methods: A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29162460/physical-exercise-in-cirrhotic-patients-towards-prehabilitation-on-waiting-list-for-liver-transplantation-a-systematic-review-and-meta-analysis
#5
Raffaele Brustia, Eric Savier, Olivier Scatton
BACKGROUND: Early survival after Liver Transplantation (LT) is reduced among sarcopenic patients. Despite, Adapted Physical Activity (APA) before LT is rarely proposed for the risk to impair portal hypertension and its resulting complications. OBJECTIVES: To assess the effects of APA program in adults affected by End Stage Liver Disease (ESLD) on hospital stay, 1-year mortality and morbidity after LT, adverse events (Primary outcomes). Secondary outcomes were changes in VO2 peak, muscle morphology, 6minutes walking distance test (6MWD), Body Mass Index (BMI), MELD, CHILD score and Hepatic Venous Pressure Gradient (HVPG)...
November 18, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/29158886/noninvasive-evaluation-of-portal-hypertension-using-a-supervised-learning-technique
#6
Mindaugas Marozas, Romanas Zykus, Andrius Sakalauskas, Limas Kupčinskas, Arūnas Lukoševičius
Portal hypertension (PHT) is a key event in the evolution of different chronic liver diseases and leads to the morbidity and mortality of patients. The traditional reliable PHT evaluation method is a hepatic venous pressure gradient (HVPG) measurement, which is invasive and not always available or acceptable to patients. The HVPG measurement is relatively expensive and depends on the experience of the physician. There are many potential noninvasive methods to predict PHT, of which liver transient elastography is determined to be the most accurate; however, even transient elastography lacks the accuracy to be a perfect noninvasive diagnostic method of PHT...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29105115/randomised-clinical-study-the-effects-of-oral-taurine-6-day%C3%A2-g-vs-placebo-daily-on-portal-hypertension
#7
R Schwarzer, D Kivaranovic, M Mandorfer, R Paternostro, D Wolrab, B Heinisch, T Reiberger, M Ferlitsch, C Gerner, M Trauner, M Peck-Radosavljevic, A Ferlitsch
BACKGROUND: The amino sulphonic acid taurine reduces oxidative endoplasmatic reticulum stress and inhibits hepatic stellate cell activation, which might lead to reduction of portal pressure in cirrhosis. AIM: To assess the haemodynamic effects of taurine supplementation in patients with cirrhosis and varices. METHODS: Patients with hepatic venous pressure gradient (HVPG) ≥12 mm Hg were included in this prospective proof of concept study...
November 3, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29102174/spleen-stiffness-is-positively-correlated-with-hvpg-and-decreases-significantly-after-tips-implantation
#8
Matthias Buechter, Paul Manka, Jens M Theysohn, Marcus Reinboldt, Ali Canbay, Alisan Kahraman
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is indicated in patients with decompensated portal hypertension (PH). Hepatic venous pressure gradient (HVPG) is considered gold standard for assessment of PH. Because HVPG measurement is invasive, non-invasive methods for evaluating severity of PH are warranted. PATIENTS AND METHODS: We retrospectively correlated spleen stiffness as measured by FibroScan with HVPG in patients who underwent TIPS. Twenty-four patients with spleen stiffness measurement (SSM) one day before (D-1), one day after (D+1) and 28 days after TIPS (D+28) were included...
October 10, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29099421/effects-of-atorvastatin-on-portal-hemodynamics-and-clinical-outcomes-in-patients-with-cirrhosis-with-portal-hypertension-a-proof-of-concept-study
#9
Saptarshi Bishnu, Sk M Ahammed, Avik Sarkar, Jabaranjan Hembram, Saswata Chatterjee, Kshaunish Das, Gopal K Dhali, Abhijit Chowdhury, Kausik Das
BACKGROUND AND AIM: Statins can modulate portal microvascular dynamics in patients with cirrhosis. We present data from a proof-of-concept study aimed at comparing combination of propranolol and atorvastatin versus propranolol alone in reducing portal pressure in patients with cirrhosis. PATIENTS AND METHODS: In this open-label proof-of-concept study, 23 consecutive patients with cirrhosis were randomized into group A (incremental dose propranolol, n=12) or group B (atorvastatin 20 mg daily with propranolol in incremental dose, n=11)...
November 2, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29042056/a-computational-model-of-the-hepatic-circulation-applied-to-analyze-the-sensitivity-of-hepatic-venous-pressure-gradient-hvpg-in-liver-cirrhosis
#10
Tianqi Wang, Fuyou Liang, Zunqiang Zhou, Lu Shi
Measurement of hepatic venous pressure gradient (HVPG) is currently widely adopted to provide an estimate of portal pressure gradient (PPG) in the diagnosis and treatment of portal hypertension associated with liver cirrhosis. Despite the well-documented clinical utility of HVPG, it remains poorly understood how the relationship between HVPG and PPG is affected by factors involved in the pathogenesis and progression of cirrhosis. In the study, a computational model of the hepatic circulation calibrated to in vivo data was developed to simulate the procedure of HVPG measurement and quantitatively investigate the error of HVPG relative to PPG under various pathophysiological conditions...
October 6, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29024353/exercise-and-physical-activity-for-patients-with-esld-improving-functional-status-and-sarcopenia-while-on-the-transplant-waitlist
#11
REVIEW
Andrés Duarte-Rojo, Astrid Ruiz-Margáin, Aldo J Montaño-Loza, Ricardo Macías-Rodríguez, Arny Ferrando, W Ray Kim
Sarcopenia and physical deconditioning are frequent complications in patients with cirrhosis and end-stage liver disease (ESLD). They are the end result of impaired dietary intake, chronic inflammation, altered macro- and micronutrient metabolism, and low physical activity. Frailty is the end result of prolonged sarcopenia and physical deconditioning. It severely affects a patient's functional status, and presents in about 1 in 5 patients on the liver transplant (LT) waitlist. Sarcopenia, poor physical fitness/cardiopulmonary endurance, and frailty are all associated with increased mortality in ESLD...
October 11, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28970710/transient-elastography-fibroscan-in-patients-with-non-cirrhotic-portal-fibrosis
#12
Praveen Sharma, Rachit Agarwal, Shashi Dhawan, Naresh Bansal, Vikas Singla, Ashish Kumar, Anil Arora
BACKGROUND: Non-cirrhotic portal hypertension (NCPH) is a common cause of variceal bleed in developing countries. Transient elastography (TE) using Fibroscan is a useful technique for evaluation of fibrosis in patients with liver disease. There is a paucity of studies evaluating TE in patients with Non-cirrhotic portal fibrosis (NCPF) and none in Asian population. Aim of this study was to evaluate role of TE in NCPF. METHODS: Retrospective data of consecutive patients of NCPF as per Asian pacific association for the study of liver (APASL) guidelines were noted...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28878671/a-pilot-study-evaluating-the-safety-of-intravenously-administered-human-amnion-epithelial-cells-for-the-treatment-of-hepatic-fibrosis
#13
Rebecca Lim, Alexander Hodge, Gregory Moore, Euan M Wallace, William Sievert
Liver cirrhosis is the 6th leading cause of death in adults aged 15-59 years in high-income countries. For many who progress to cirrhosis, the only prospect for survival is liver transplantation. While there is some indication that mesenchymal stem cells may be useful in reversing established liver fibrosis, there are limitations to their widespread use - namely their rarity, the need for extensive serial passaging and the associated potential for genomic instability and cellular senescence. To this end, we propose the use of allogeneic amnion epithelial cells...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28855918/effects-of-a-long-acting-formulation-of-octreotide-on-patients-with-portal-hypertension
#14
Pei-Jing Cui, Jing Yao, Yin Zhu, Zheng-Yun Zhang, Jun Yang
OBJECTIVE: This study aimed to determine whether the treatment of a long-acting formulation of octreotide (OCT-LAR) exerted a similar effect on improving the prognosis of patients with portal hypertension compared with placement of transjugular intrahepatic portosystemic shunts (TIPSs). METHODS: A total of 24 patients with portal hypertension who underwent TIPS placement or OCT-LAR treatment from January 2010 to January 2015 were reviewed. Hemodynamic studies, biological values, live functions, and treatment complications before and during the treatment were evaluated...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28820885/diagnostic-efficacy-of-noninvasive-liver-fibrosis-indexes-in-predicting-portal-hypertension-in-patients-with-cirrhosis
#15
Le Wang, Yuemin Feng, Xiaowen Ma, Guangchuan Wang, Hao Wu, Xiaoyu Xie, Chunqing Zhang, Qiang Zhu
BACKGROUND: Recent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated. AIMS: To evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. METHODS: A total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade...
2017: PloS One
https://www.readbyqxmd.com/read/28765688/impact-of-hepatitis-c-oral-therapy-in-portal-hypertension
#16
EDITORIAL
Diogo Libânio, Rui Tato Marinho
Chronic hepatitis C is a leading cause of morbidity and mortality, mainly related to fibrosis/cirrhosis and portal hypertension. Direct antiviral agents are highly effective and safe and can now cure > 90% of the patients. Sustained viral response (SVR) after interferon-based regimens has been associated with improvement in liver function, fibrosis and portal hypertension in a significant proportion of patients, although a point of no return seems to exist from which viral elimination is no longer capable of preventing portal hypertension progression and liver decompensation...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28752925/management-of-portal-hypertension-before-and-after-liver-transplantation
#17
L W Unger, G Berlakovich, M Trauner, T Reiberger
Orthotopic liver transplantation (OLT) represents a curative treatment option for end-stage liver disease (ESLD). While epidemiology of ESLD has recently changed due the rising prevalence of non-alcoholic fatty liver disease (NAFLD) and decreased burden of hepatitis C virus (HCV) infections due to highly-effective antiviral regimens, the management of portal hypertension (PHT) remains a clinical challenge in the pre- and post-OLT setting. The measurement of hepatic venous pressure gradient (HVPG) represents the most reliable, but invasive tool for assessment of the severity of PHT...
July 28, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28734831/effects-of-all-oral-anti-viral-therapy-on-hvpg-and-systemic%C3%A2-hemodynamics-in-patients-with-hepatitis-c-virus-associated-cirrhosis
#18
Sabela Lens, Edilmar Alvarado-Tapias, Zoe Mariño, María-Carlota Londoño, Elba LLop, Javier Martinez, Jose Ignacio Fortea, Luís Ibañez, Xavier Ariza, Anna Baiges, Adolfo Gallego, Rafael Bañares, Angela Puente, Agustín Albillos, Jose Luís Calleja, Xavier Torras, Virginia Hernández-Gea, Jaume Bosch, Cándid Villanueva, Xavier Forns, Juan Carlos García-Pagán
BACKGROUND & AIMS: Patients with hepatitis C virus-associated cirrhosis and clinical significant portal hypertension (CSPH, hepatic venous pressure gradient [HVPG] 10 mmHg or greater), despite achieving sustained virological response (SVR) to therapy, remain at risk of liver decompensation. We investigated hemodynamic changes following SVR in patients with CSPH and whether liver stiffness measurements (LSMs) can rule out the presence of CSPH. METHODS: We performed a multicenter prospective study of 226 patients with hepatitis C virus-associated cirrhosis and CSPH who had SVR to interferon-free therapy at 6 Liver Units in Spain...
November 2017: Gastroenterology
https://www.readbyqxmd.com/read/28711320/liver-stiffness-measurement-by-transient-elastography-predicts-late-posthepatectomy-outcomes-in-patients-undergoing-resection-for-hepatocellular-carcinoma
#19
Muthukumarassamy Rajakannu, Daniel Cherqui, Oriana Ciacio, Nicolas Golse, Gabriella Pittau, Marc Antoine Allard, Teresa Maria Antonini, Audrey Coilly, Antonio Sa Cunha, Denis Castaing, Didier Samuel, Catherine Guettier, René Adam, Eric Vibert
BACKGROUND: Postoperative hepatic decompensation is a serious complication of liver resection in patients undergoing hepatectomy for hepatocellular carcinoma. Liver fibrosis and clinical significant portal hypertension are well-known risk factors for hepatic decompensation. Liver stiffness measurement is a noninvasive method of evaluating hepatic venous pressure gradient and functional hepatic reserve by estimating hepatic fibrosis. Effectiveness of liver stiffness measurement in predicting persistent postoperative hepatic decompensation has not been investigated...
October 2017: Surgery
https://www.readbyqxmd.com/read/28702738/impact-of-etiological-treatment-on-prognosis
#20
REVIEW
Chien-Wei Su, Ying-Ying Yang, Han-Chieh Lin
Portal hypertension (PHT) is a frequent and severe complication of cirrhosis. PHT may lead to the development of various complications with high mortality. Liver transplantation is the gold standard as a surgical curative treatment for end-stage liver disease. Theoretically, etiological treatment focusing on the pathophysiology of the underlying disease should be the objective of the nonsurgical management of cirrhotic PHT. Chronic viral hepatitis is the major etiology of cirrhosis and PHT. In cirrhotic patients with chronic hepatitis B virus infection, antiviral therapies can suppress viral replication, ameliorate hepatic inflammation, regress fibrosis, and restore liver functional reserve...
July 12, 2017: Hepatology International
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