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Hepatic venous pressure gradient

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https://www.readbyqxmd.com/read/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#1
P Schwabl, M Mandorfer, S Steiner, B Scheiner, D Chromy, M Herac, T Bucsics, H Hayden, K Grabmeier-Pfistershammer, A Ferlitsch, G Oberhuber, M Trauner, M Peck-Radosavljevic, T Reiberger
BACKGROUND: HIV/HCV co-infected patients show accelerated fibrosis progression and higher risk for complications of portal hypertension (PHT). AIM: To assess the effects of interferon-free therapy on portal pressure, liver histology and plasma biomarkers in HIV/HCV-coinfected patients with PHT. METHODS: Twenty-two patients with paired hepatic venous pressure gradient (HVPG) measurements prior and after successful treatment (SVR) with interferon-free regimens were included...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27906797/non-cirrhotic-portal-fibrosis-in-pediatric-population
#2
Vikrant Sood, Bikrant Bihari Lal, Rajeev Khanna, Dinesh Rawat, Chhagan Bihari Sharma, Seema Alam
BACKGROUND: Non-cirrhotic portal fibrosis (NCPF) has been classically described as a disease of young to middle age with limited literature regarding its occurrence, onset or clinical presentation in children. We hereby present a series of 19 patients diagnosed and managed as NCPF in pediatric age group. METHODS: A retrospective review of all the patients presenting to the pediatric hepatology department (age < 18 years) and diagnosed as NCPF was done and data was evaluated...
November 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27888359/low-25-oh-vitamin%C3%A2-d-levels-reflect-hepatic-dysfunction-and-are-associated-with-mortality-in-patients-with-liver-cirrhosis
#3
Rafael Paternostro, Doris Wagner, Thomas Reiberger, Mattias Mandorfer, Remy Schwarzer, Monika Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Arnulf Ferlitsch
BACKGROUND AND AIMS: Vitamin D deficiency is frequent in patients with cirrhosis. The aims of this study were to evaluate the relation of vitamin D status to portal hypertension, degree of liver dysfunction and survival. METHODS: Patients with cirrhosis who have been tested for 25-OH-vitamin D levels were retrospectively included. Vitamin D deficiency was defined as 25-OH-vitamin D levels <10 ng/ml. Child-Pugh score, model for end-stage liver disease (MELD) and available hepatic venous pressure gradient (HVPG) were recorded...
November 25, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27805917/caval-subtraction-2d-phase-contrast-mri-to-measure-total-liver-and-hepatic-arterial-blood-flow-proof-of-principle-correlation-with-portal-hypertension-severity-and-validation-in-patients-with-chronic-liver-disease
#4
Manil D Chouhan, Rajeshwar P Mookerjee, Alan Bainbridge, Shonit Punwani, Helen Jones, Nathan Davies, Simon Walker-Samuel, David Patch, Rajiv Jalan, Steve Halligan, Mark F Lythgoe, Stuart A Taylor
OBJECTIVES: Caval subtraction phase-contrast magnetic resonance imaging (PCMRI) noninvasive measurements of total liver blood flow (TLBF) and hepatic arterial (HA) flow have been validated in animal models and translated into normal volunteers, but not patients. This study aims to demonstrate its use in patients with liver cirrhosis, evaluate measurement consistency, correlate measurements with portal hypertension severity, and invasively validate TLBF measurements. MATERIALS AND METHODS: Local research ethics committee approval was obtained...
October 31, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27775818/rifaximin-has-no-effect-on-hemodynamics-in-decompensated-cirrhosis-a-randomized-double-blind-placebo-controlled-trial
#5
Nina Kimer, Julie Steen Pedersen, Troels Malte Busk, Lise Lotte Gluud, Lise Hobolth, Aleksander Krag, Søren Møller, Flemming Bendtsen
BACKGROUND AND RATIONALE: Decompensated cirrhosis is characterized by disturbed systemic and splanchnic hemodynamics. Bacterial translocation from the gut is considered the key driver in this process. Intestinal decontamination with rifaximin may improve hemodynamics. This double-blind, randomized, controlled trial investigates the effects of rifaximin on hemodynamics, renal function and vasoactive hormones. METHODS: We randomized 54 stable out-patients with cirrhosis and ascites to rifaximin 550 mg BD (n=36) or placebo BD (n=18)...
October 24, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27756066/spleen-and-liver-stiffness-is-positively-correlated-with-the-risk-of-esophageal-variceal-bleeding
#6
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Christoph Jochum, Ali Canbay, Alexander Dechêne
BACKGROUND/AIMS: Portal hypertension (PH) is a common complication of chronic liver disease and results in esophageal and gastric variceal bleeding, which is associated with a high mortality rate. Measurement of the hepatic venous pressure gradient (HVPG) is considered the gold standard for diagnosing PH and estimating the risk of varices and bleeding. In contrast, upper gastrointestinal (GI) endoscopy (UGE) can reliably demonstrate the presence of varices and bleeding. Both measures are invasive, and HVPG is mainly restricted to tertiary centers...
October 19, 2016: Digestion
https://www.readbyqxmd.com/read/27751595/a-meta-analysis-for-the-diagnostic-performance-of-transient-elastography-for-clinically-significant-portal-hypertension
#7
REVIEW
Myung-Won You, Kyung Won Kim, Junhee Pyo, Jimi Huh, Hyoung Jung Kim, So Jung Lee, Seong Ho Park
We aimed to evaluate the correlation between liver stiffness measurement using transient elastography (TE-LSM) and hepatic venous pressure gradient and the diagnostic performance of TE-LSM in assessing clinically significant portal hypertension through meta-analysis. Eleven studies were included from thorough literature research and selection processes. The summary correlation coefficient was 0.783 (95% confidence interval [CI], 0.737-0.823). Summary sensitivity, specificity and area under the hierarchical summary receiver operating characteristic curve (AUC) were 87...
January 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27746615/non-invasive-diagnosis-of-oesophageal-varices-using-systemic-haemodynamic-measurements-by-finometry-comparison-with-other-non-invasive-predictive-scores
#8
Kara Rye, Gerri Mortimore, Andrew Austin, Jan Freeman
BACKGROUND/AIMS: Cirrhosis and portal hypertension are characterised by a hyperdynamic circulation, which is independently associated with variceal size. Non-invasive techniques for measurement of systemic haemodynamics are now available. The aim of the study was to prospectively assess the accuracy of systemic haemodynamics measured non-invasively for the detection of oesophageal varices in cirrhotic patients as compared to other currently available non-invasive methods. METHODS: In a study of 29 cirrhotic patients, systemic haemodynamics were studied non-invasively using the Finometer(®) (mean arterial pressure (MAP), cardiac output (CO)/index, heart rate (HR), peripheral vascular resistance) and portal pressure was assessed by hepatic venous pressure gradient...
September 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27718326/potential-use-of-metabolic-breath-tests-to-assess-liver-disease-and-prognosis-has-the-time-arrived-for-routine-use-in-the-clinic
#9
REVIEW
R Todd Stravitz, Yaron Ilan
The progression of liver disease may be unique among organ system diseases in that progressive fibrosis compromises not only the sufficiency of hepatocyte mass but also impairs blood flow to the liver, resulting in porto-systemic shunting. Although liver biopsy as an assessment of fibrosis has become the key biomarker of and target for new therapies, it is invasive and subject to sampling error, and cannot quantify metabolic function or porto-systemic shunting. Measurement of the hepatic venous pressure gradient accommodates some of the deficiencies of biopsy but requires expertise not widely available and misses minor changes in hepatocellular mass and thereby information about metabolic function...
October 8, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27714681/asian-pacific-association-for-the-study-of-the-liver-apasl-consensus-guidelines-on-invasive-and-non-invasive-assessment-of-hepatic-fibrosis-a-2016-update
#10
Gamal Shiha, Alaa Ibrahim, Ahmed Helmy, Shiv Kumar Sarin, Masao Omata, Ashish Kumar, David Bernstien, Hitushi Maruyama, Vivek Saraswat, Yogesh Chawla, Saeed Hamid, Zaigham Abbas, Pierre Bedossa, Puja Sakhuja, Mamun Elmahatab, Seng Gee Lim, Laurentius Lesmana, Jose Sollano, Ji-Dong Jia, Bahaa Abbas, Ashraf Omar, Barjesh Sharma, Diana Payawal, Ahmed Abdallah, Abdelhamid Serwah, Abdelkhalek Hamed, Aly Elsayed, Amany AbdelMaqsod, Tarek Hassanein, Ahmed Ihab, Hamsik GHaziuan, Nizar Zein, Manoj Kumar
Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated...
October 6, 2016: Hepatology International
https://www.readbyqxmd.com/read/27693644/eus-guided-portal-pressure-gradient-measurement-with-a-simple-novel-device-a-human-pilot-study
#11
Jason Y Huang, Jason B Samarasena, Takeshi Tsujino, John Lee, Ke-Qin Hu, Christine E McLaren, Wen-Pin Chen, Kenneth J Chang
BACKGROUND & AIMS: Portal hypertension (PH) is a serious adverse event of liver cirrhosis. The hepatic venous pressure gradient or portal pressure gradient (PPG) accurately reflects the degree of PH and is the single best prognostic indicator in liver disease. This is usually obtained by interventional radiology (IR) although it is not routinely performed. Recently, we developed a simple novel technique for EUS-guided PPG measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and IR-PPGM...
September 29, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27661973/prognostic-significance-of-hemodynamic-and-clinical-stages-in-the-prediction-of-hepatocellular-carcinoma
#12
Ki Tae Suk, Eun Jin Kim, Dong Joon Kim, Hyo Sun Kim, Chang Seok Bang, Tae Young Park, Gwang Ho Baik, Sung Eun Kim, Ji Won Park, Sang Hoon Park, Myung Seok Lee, Hyoung Su Kim, Myoung Kuk Jang, Seung Ha Park, Eunhee Choi, Chang H Kim, Hotaik Sung, Choong Kee Park
BACKGROUND & GOALS: Early identification of hepatocellular carcinoma (HCC) is associated with improved survival for patients with chronic liver disease (CLD). We evaluated the prognostic significance of hemodynamic stage (HS) and clinical stage (CS) in predicting HCC in CLD patients. METHODS: Between January 2006 and May 2014, 801 patients with CLD who underwent hepatic venous pressure gradient (HVPG) measurement were prospectively enrolled. HS was classified by HVPG (mm Hg) as follows: HS-1 (HVPG≤6), HS-2 (6<HVPG≤10), HS-3 (10<HVPG≤12), HS-4 (12<HVPG≤20), and HS-5 (20<HVPG)...
September 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27624505/carvedilol-versus-propranolol-effect-on-hepatic-venous-pressure-gradient-at-1%C3%A2-month-in-patients-with-index-variceal-bleed-rct
#13
Vipin Gupta, Ramakant Rawat, Shalimar, Anoop Saraya
BACKGROUND AND AIMS: Endoscopic variceal ligation (EVL) plus beta blocker is the mainstay treatment after index bleed to prevent rebleed. Primary objective of this study was to compare EVL plus propranolol versus EVL plus carvedilol on reduction of HVPG after 1 month of therapy. METHODS: Patients of cirrhosis presenting with index esophageal variceal bleed received standard treatment (Somatostatin therapy f/b EVL) following which HVPG was measured and patients were randomized to propranolol or carvedilol group if HVPG was >12 mmHg...
September 13, 2016: Hepatology International
https://www.readbyqxmd.com/read/27575713/a-randomized-multi-center-open-label-study-to-evaluate-the-efficacy-of-carvedilol-vs-propranolol-to-reduce-portal-pressure-in-patients-with-liver-cirrhosis
#14
Sang G Kim, Tae Y Kim, Joo H Sohn, Soon H Um, Yeon S Seo, Soon K Baik, Moon Y Kim, Jae Y Jang, Soung W Jeong, Bora Lee, Young S Kim, Ki T Suk, Dong J Kim
OBJECTIVES: Propranolol has been used as prophylaxis for variceal bleeding in patients with cirrhosis. More recent data suggest that carvedilol may be more effective for reducing the hepatic venous pressure gradient (HVPG) than propranolol. The primary aim of this study was to evaluate the hemodynamic response to carvedilol compared with propranolol. METHODS: A total of 110 patients with a baseline HVPG value >12 mm Hg were allocated randomly to receive either carvedilol or propranolol...
August 30, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27566593/hvpg-signature-a-prognostic-and-predictive-tool-in-hepatocellular-carcinoma
#15
Xiaolong Qi, Xin Zhang, Zhijia Li, Jialiang Hui, Yi Xiang, Jinjun Chen, Jianbo Zhao, Jing Li, Fu-Zhen Qi, Yong Xu
Hepatic venous pressure gradient (HVPG) measurement provides independent prognostic value in patients with cirrhosis, and the prognostic and predictive role of HVPG in hepatocellular carcinoma (HCC) also has been explored. The management of HCC is limited to the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) guidelines that consider that HVPG≥10 mmHg to be a contraindication for hepatic resection (HR), otherwise other treatment modalities are recommended...
August 23, 2016: Oncotarget
https://www.readbyqxmd.com/read/27495217/diagnostic-hepatic-hemodynamic-techniques-safety-and-radiation-exposure
#16
Andrej Hari, Hari Kumar Nair, Andrea De Gottardi, Iris Baumgartner, Jean-François Dufour, Annalisa Berzigotti
BACKGROUND & AIMS: Hepatic venous pressure gradient (HVPG) and transjugular liver biopsy (TJLB) are increasingly used in the management of patients with liver disease. We aimed to describe the safety profile of these procedures, providing data on the intra- and peri-procedure complications, radiation exposure, and amount of iodinated contrast material used. METHODS: In 106 consecutive patients undergoing HVPG and TJLB data on fluoroscopy time (FT), absorbed radiation dose, equivalent effective dose (mSv), and volume of iodinated contrast material (ICM) were prospectively collected and reviewed, together with clinical and laboratory data...
August 6, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27475617/non-invasive-assessment-of-portal-hypertension-using-quantitative-magnetic-resonance-imaging
#17
Naaventhan Palaniyappan, Eleanor Cox, Christopher Bradley, Robert Scott, Andrew Austin, Richard O'Neill, Greg Ramjas, Simon Travis, Hilary White, Rajeev Singh, Peter Thurley, Indra Neil Guha, Susan Francis, Guruprasad Padur Aithal
BACKGROUND & AIMS: Hepatic venous pressure gradient (HVPG) measurement is currently the only validated technique to accurately evaluate changes in portal pressure. In this study, we evaluate the use of non-contrast quantitative magnetic resonance imaging (MRI) as a surrogate measure of portal pressure. METHODS: Thirty patients undergoing HVPG measurement were prospectively recruited. MR parameters of longitudinal relaxation time (T1), perfusion of the liver and spleen (by arterial spin labelling), and blood flow in the portal, splanchnic and collateral circulation (by phase contrast MRI) were assessed...
December 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27470625/-clinical-value-of-contrast-enhanced-ultrasound-in-evaluating-portal-hypertension-in-patients-with-decompensated-liver-cirrhosis
#18
Y Zhuang, H Ding, H Han, F Mao, J J Luo, S Y Chen, W P Wang
OBJECTIVE: To investigate the correlation between contrast-enhanced ultrasound parameters and hepatic venous pressure gradient (HVPG), and to develop a new noninvasive method for the evaluation of portal hypertension in patients with decompensated liver cirrhosis. METHODS: One-hundred patients with decompensated liver cirrhosis were examined by contrast-enhanced ultrasound, and the dynamic images were collected for offline analysis. The contrast arrival time was obtained in the hepatic artery (HA), portal vein (PV), and hepatic vein (HV), and HA-HV transit time (HA-HVTT) and PV-HV transit time (PV-HVTT) were calculated...
April 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27449976/calculating-hepatic-venous-pressure-gradient-feel-free-to-stay-free
#19
Jaime Bosch, Juan Carlos García-Pagán
No abstract text is available yet for this article.
August 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27440720/two-dimensional-shear-wave-elastography-with-propagation-based-reliability-assessment-for-grading-hepatic-fibrosis-and-portal-hypertension
#20
Hitoshi Maruyama, Kazufumi Kobayashi, Soichiro Kiyono, Tadashi Sekimoto, Tatsuo Kanda, Osamu Yokosuka
BACKGROUND: The aim of the present study was to examine the diagnostic ability of two-dimensional shear wave elastography (2D-SWE) with propagation-based reliability for grading of hepatic fibrosis and portal hypertension. METHODS: This prospective study (UMIN000022838) consisted of 135 subjects. Phase I (n = 40) examined the effect of standard deviation (SD)/median as the reliability criterion of 2D-SWE, and phase II (n = 95) compared the diagnostic ability of 2D-SWE under the best SD/median value and transient elastography (TE)...
September 2016: Journal of Hepato-biliary-pancreatic Sciences
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