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Hepatic venous pressure gradient

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https://www.readbyqxmd.com/read/28651304/rifaximin-and-propranolol-combination-therapy-is-more-effective-than-propranolol-monotherapy-for-the-reduction-of-portal-pressure-an-open-randomized-controlled-pilot-study
#1
Yoo Li Lim, Moon Young Kim, Yoon Ok Jang, Soon Koo Baik, Sang Ok Kwon
Background/Aims: Non-selective beta blockers (NSBBs) are currently the only accepted regimen for preventing portal hypertension (PHT)-related complications. However, the effect of NSBBs is insufficient in many cases. Bacterial translocation (BT) is one of the aggravating factors of PHT in cirrhosis; therefore, selective intestinal decontamination by rifaximin is a possible therapeutic option for improving PHT. We investigated whether the addition of rifaximin to propranolol therapy can improve hepatic venous pressure gradient (HVPG) response...
June 27, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28622247/effects-of-portal-hypertension-on-gadoxetic-acid-enhanced-liver-magnetic-resonance-diagnostic-and-prognostic-implications
#2
Ulrika Asenbaum, Ahmed Ba-Ssalamah, Mattias Mandorfer, Richard Nolz, Julia Furtner, Thomas Reiberger, Arnulf Ferlitsch, Klaus Kaczirek, Michael Trauner, Markus Peck-Radosavljevic, Andreas G Wibmer
OBJECTIVE: The aim of this study was to investigate the impact of portal hypertension (PH) on gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) and assess diagnostic and prognostic implications in comparison to established imaging features of PH. MATERIALS AND METHODS: Institutional review board-approved retrospective study of 178 patients (142 men; median age, 59.4 years) with chronic liver disease undergoing MRI and hepatic venous pressure gradient (HVPG) measurement between January 2008 and April 2015...
June 16, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28533906/diagnosis-of-cirrhosis-and-portal-hypertension-imaging-non-invasive-markers-of-fibrosis-and-liver-biopsy
#3
REVIEW
Bogdan Procopet, Annalisa Berzigotti
The concept of 'cirrhosis' is evolving and it is now clear that compensated and decompensated cirrhosis are completely different in terms of prognosis. Furthermore, the term 'advanced chronic liver disease (ACLD)' better reflects the continuum of histological changes occurring in the liver, which continue to progress even after cirrhosis has developed, and might regress after removing the etiological factor causing the liver disease. In compensated ACLD, portal hypertension marks the progression to a stage with higher risk of clinical complication and requires an appropriate evaluation and treatment...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28480218/magnetic-resonance-elastography-shear-wave-velocity-correlates-with-liver-fibrosis-and-hepatic-venous-pressure-gradient-in-adults-with-advanced-liver-disease
#4
Ahmed M Gharib, Ma Ai Thanda Han, Eric G Meissner, David E Kleiner, Xiongce Zhao, Mary McLaughlin, Lindsay Matthews, Bisharah Rizvi, Khaled Z Abd-Elmoniem, Ralph Sinkus, Elliot Levy, Christopher Koh, Robert P Myers, G Mani Subramanian, Shyam Kottilil, Theo Heller, Joseph A Kovacs, Caryn G Morse
Background. Portal hypertension, an elevation in the hepatic venous pressure gradient (HVPG), can be used to monitor disease progression and response to therapy in cirrhosis. Since obtaining HVPG measurements is invasive, reliable noninvasive methods of assessing portal hypertension are needed. Methods. Noninvasive markers of fibrosis, including magnetic resonance elastography (MRE) shear wave velocity, were correlated with histologic fibrosis and HVPG measurements in hepatitis C (HCV) and/or HIV-infected patients with advanced liver disease enrolled in a clinical trial of treatment with simtuzumab, an anti-LOXL2 antibody...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28474176/hepatic-venous-pressure-gradient-correlates-with-advanced-hepatic-fibrosis-a-retrospective-review
#5
Jonathan K Vincent, Christopher Stark, Joseph T Shields, Anant D Bhave, Christopher S Morris
PURPOSE: To determine if hepatic venous pressure gradient (HVPG) correlates with advanced hepatic fibrosis, as a complement to transjugular (transvenous) core needle liver biopsy. MATERIALS AND METHODS: After institutional review board approval, a retrospective review was conducted on 340 patients who underwent transjugular (transvenous) core needle liver biopsy with concurrent pressure measurements between 6/1/2007 and 6/1/2013. Spearman correlation and linear regression were performed...
May 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28437324/noncirrhotic-portal-fibrosis-in-pediatric-population
#6
Vikrant Sood, Bikrant B Lal, Rajeev Khanna, Dinesh Rawat, Chhagan Bihari, Seema Alam
OBJECTIVES: Noncirrhotic 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 were evaluated...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28361299/invasive-and-non-invasive-assessment-of-portal-hypertension
#7
REVIEW
Jonathan Chung-Fai Leung, Thomson Chi-Wang Loong, James Pang, Jeremy Lok Wei, Vincent Wai-Sun Wong
Portal hypertension is the central driver of complications in patients with chronic liver diseases and cirrhosis. The diagnosis of portal hypertension has important prognostic and clinical implications. In particular, screening for varices in patients with portal hypertension can effectively reduce the morbidity and mortality of variceal bleeding. In this article, we review the invasive and non-invasive methods to assess portal hypertension. Hepatic venous pressure gradient remains the gold standard to measure portal pressure but is invasive and seldom performed outside expert centers and research settings...
March 30, 2017: Hepatology International
https://www.readbyqxmd.com/read/28321540/ct-perfusion-imaging-of-the-liver-and-the-spleen-in-patients-with-cirrhosis-is-there-a-correlation-between-perfusion-and-portal-venous-hypertension
#8
Emina Talakić, Silvia Schaffellner, Daniela Kniepeiss, Helmut Mueller, Rudolf Stauber, Franz Quehenberger, Helmut Schoellnast
OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL)...
March 20, 2017: European Radiology
https://www.readbyqxmd.com/read/28295923/effect-of-viral-suppression-on-hepatic-venous-pressure-gradient-in-hepatitis-c-with-cirrhosis-and-portal-hypertension
#9
N Afdhal, G T Everson, J L Calleja, G W McCaughan, J Bosch, D M Brainard, J G McHutchison, S De-Oertel, D An, M Charlton, K R Reddy, T Asselah, E Gane, M P Curry, X Forns
Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment...
March 10, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28282272/role-of-serum-soluble-cd163-in-the-diagnosis-risk-of-bleeding-and-prognosis-of-gastro-esophageal-varices-in-cirrhotic-patients
#10
Rabab Fouad, Iman Hamza, Marwa Khairy, Marwa Elsharkawy, Amal A Helmy
Research is continuous for noninvasive tools for the prediction of portal hypertension than upper gastrointestinal endoscopy. Serum sCD163 correlates with hepatic venous pressure gradient, aiding in the prediction of portal hypertension. We aimed at investigating the role of sCD163 in the prediction of the presence and size of varices as well as a stratification tool for surveillance or prophylaxis by assessment of prognosis and risk of bleeding. Two hundred forty-three cirrhotic patients were divided into 3 groups: group I: no varices, group II: small-sized varices, and group III: medium-sized and large-sized varices...
March 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/28263953/transient-elastography-versus-hepatic-venous-pressure-gradient-for-diagnosing-portal-hypertension-a-systematic-review-and-meta-analysis
#11
REVIEW
Gaeun Kim, Moon Young Kim, Soon Koo Baik
BACKGROUND/AIMS: Transient elastography (TE) has been proposed as a promising noninvasive alternative to hepatic venous pressure gradient (HVPG) for detecting portal hypertension (PH). However, previous studies have yielded conflicting results. We gathered evidence from literature on the clinical usefulness of TE versus HVPG for assessing PH. METHODS: We conducted a systematic review by searching databases for relevant literature evaluating the clinical usefulness of non-invasive TE for assessing PH in patients with cirrhosis...
March 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28261384/addition-of-simvastatin-to-carvedilol-non-responders-a-new-pharmacological-therapy-for-treatment-of-portal-hypertension
#12
Zeeshan Ahmad Wani, Sonmoon Mohapatra, Afaq Ahmad Khan, Ashutosh Mohapatra, Ghulam Nabi Yatoo
AIM: To determine whether addition of simvastatin could be an important pharmacological rescue therapy for carvedilol non-responders. METHODS: One hundred and two consecutive patients of cirrhosis of liver with significant portal hypertension were included. Hepatic venous pressure gradient (HVPG) was measured at the base line and after proper optimization of dose; chronic response was assessed at 3 mo. Carvedilol non-responders were given simvastatin 20 mg per day (increased to 40 mg per day at day 15)...
February 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28223101/non-invasive-evaluation-of-portal-hypertension-using-ultrasound-elastography
#13
REVIEW
Annalisa Berzigotti
Portal hypertension (PH) leads to serious complications, such as bleeding from gastroesophageal varices, ascites and portosystemic encephalopathy in patients with chronic liver disease (CLD). Gold standard methods for assessing PH and its complications include the measurement of hepatic venous pressure gradient and endoscopy; however, these are invasive, expensive and not available at all centres. Therefore, non-invasive alternatives have been the subject of extensive investigation over the last 20years. The present review focuses on the role of ultrasound elastography - a novel group of non-invasive techniques used to measure stiffness in target organs...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28216976/correlation-of-transient-elastography-with-hepatic-venous-pressure-gradient-in-patients-with-cirrhotic-portal-hypertension-a-study-of-326-patients-from-india
#14
Ashish Kumar, Noor Muhammad Khan, Shrihari Anil Anikhindi, Praveen Sharma, Naresh Bansal, Vikas Singla, Anil Arora
AIM: To study the diagnostic accuracy of transient elastography (TE) for detecting clinically significant portal hypertension (CSPH) in Indian patients with cirrhotic portal hypertension. METHODS: This retrospective study was conducted at the Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, on consecutive patients with cirrhosis greater than 15 years of age who underwent hepatic venous pressure gradient (HVPG) and TE from July 2011 to May 2016...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28201851/the-design-of-clinical-trials-in-portal-hypertension
#15
Juan G Abraldes, Guadalupe Garcia-Tsao
Portal hypertension (PH) is the main consequence of cirrhosis and is responsible for the majority of its complications. Gastroesophageal varices and variceal hemorrhage are direct consequences of PH; therefore, most clinical trials in PH have been directed toward treating or preventing variceal hemorrhage. However, varices and variceal hemorrhage are not isolated events; they must be considered in the context of the presence (or absence) of other complications of cirrhosis/PH. Cirrhosis progresses across different stages, each with a different prognosis and pathophysiology and hence different therapeutic targets...
February 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28107286/liver-stiffness-measured-by-shear-wave-elastography-for-evaluating-intrahepatic-portal-hypertension-in-children
#16
Hee Mang Yoon, So Yeon Kim, Kyung Mo Kim, Seak Hee Oh, Gi-Young Ko, Yangsoon Park, Jin Seong Lee, Ah Young Jung, Young Ah Cho
OBJECTIVES: The aim of the study was to correlate liver stiffness (LS) and hepatic venous-pressure gradient (HVPG) and to evaluate the diagnostic performance of shear-wave elastography (SWE) for predicting clinically significant portal hypertension in children with suspected liver diseases, in consideration of the reliability criteria. METHODS: We identified 33 SWEs from 32 children who underwent HVPG measurement within 2 weeks between June 2012 and October 2015...
June 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28104976/clinical-role-of-non-invasive-assessment-of-portal-hypertension
#17
EDITORIAL
Massimo Bolognesi, Marco Di Pascoli, David Sacerdoti
Measurement of portal pressure is pivotal in the evaluation of patients with liver cirrhosis. The measurement of the hepatic venous pressure gradient represents the reference method by which portal pressure is estimated. However, it is an invasive procedure that requires significant hospital resources, including experienced staff, and is associated with considerable cost. Non-invasive methods that can be reliably used to estimate the presence and the degree of portal hypertension are urgently needed in clinical practice...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28079667/stage-of-fibrosis-and-portal-pressure-correlation-in-nonalcoholic-steatohepatitis
#18
Achuthan Sourianarayanane, Jyothsna Talluri, Abinav Humar, Arthur J McCullough
BACKGROUND: Hepatic venous pressure gradient (HVPG) measurement correlates with staging of liver fibrosis. Patients with nonalcoholic steatohepatitis (NASH) have a different pattern of fibrosis compared with hepatitis C virus (HCV) with possible alterations in pressures. AIM: The aim of this study was to compare portal pressures with the stage of fibrosis in NASH in comparison with other liver diseases. PATIENTS AND METHODS: Records of all patients who had undergone transjugular liver biopsy with pressure measurements between January 2001 and June 2013 were reviewed...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28032548/simplified-technique-for-75-and-90-hepatic-resection-with-hemodynamic-monitoring-in-a-large-white-swine-model
#19
Petru Bucur, Mohamed Bekheit, Chloe Audebert, Irene Vignon-Clementel, Eric Vibert
BACKGROUND: Accurate measuring of the hepatic hemodynamic parameters in humans is inconvenient. Swine has been a favorite surgical model for the study of liver conditions due to many similarities with human livers. However, pigs cannot tolerate pedicle clamping and to reduce bleeding during resection a simplified technique is required. The aim of this study is to present a simplified technique for different percentages of hepatic resection in a porcine model. METHODS: Twenty-two consecutive large white pigs were operated with 75% and 90% liver resection...
September 30, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28017842/measurement-of-spleen-stiffness-with-acoustic-radiation-force%C3%A2-impulse-imaging-predicts-mortality-and-hepatic-decompensation-in-patients-with-liver-cirrhosis
#20
Yoshitaka Takuma, Youichi Morimoto, Hiroyuki Takabatake, Nobuyuki Toshikuni, Junko Tomokuni, Akiko Sahara, Kazuhiro Matsueda, Hiroshi Yamamoto
BACKGROUND & AIMS: Hepatic venous pressure gradient can predict mortality and hepatic decompensation in patients with cirrhosis. Measurement of hepatic venous pressure gradient requires an invasive procedure; therefore, prognostic markers are needed that do not require invasive procedures. We investigated whether measurements of spleen stiffness, made by acoustic radiation force impulse (ARFI) imaging, associated with mortality and decompensation in patients with cirrhosis, compared with liver stiffness and other markers...
December 23, 2016: Clinical Gastroenterology and Hepatology
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