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Hepatic venous pressure gradient

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https://www.readbyqxmd.com/read/28079667/stage-of-fibrosis-and-portal-pressure-correlation-in-nonalcoholic-steatohepatitis
#1
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...
January 10, 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
#2
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-impulse-imaging-predicts-mortality-and-hepatic-decompensation-in-patients-with-liver-cirrhosis
#3
Yoshitaka Takuma, Youichi Morimoto, Hiroyuki Takabatake, Nobuyuki Toshikuni, Junko Tomokuni, Akiko Sahara, Kazuhiro Matsueda, Hiroshi Yamamoto
BACKGROUND & AIMS: Hepatic venous pressure gradient (HVPG) can predict mortality and hepatic decompensation in patients with cirrhosis. Measurement of HVPG requires an invasive procedure; prognostic markers are needed that do not require invasive procedures. We investigated whether measurements of spleen stiffness, made by acoustic radiation force impulse (AFRI) imaging, associated with mortality and decompensation in patients with cirrhosis, compared to liver stiffness and other markers...
December 22, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28002118/hemodynamic-response-to-primary-prophylactic-therapy-with-nonselective-%C3%AE-blockers-is-related-to-a-reduction-of-first-variceal-bleeding-risk-in-liver-cirrhosis-a-meta-analysis
#4
Annarein J C Kerbert, Fang W T Chiang, Mark van der Werf, Theo Stijnen, Hilde Slingerland, Hein W Verspaget, Bart van Hoek, Minneke J Coenraad
The current primary prophylaxis for esophageal variceal bleeding in cirrhotic patients consists of nonselective β-blocker (NSBB) therapy. However, only approximately half of the patients achieve a sufficient hemodynamic response to NSBB therapy. Clinical application of hemodynamic response monitoring is still under debate. The aim of this meta-analysis is to assess the potential clinical value of monitoring the hemodynamic response to NSBB therapy using hepatic venous pressure gradient (HVPG) measurements in the primary prophylaxis for variceal bleeding...
December 20, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27997989/effects-of-an-intensive-lifestyle-intervention-program-on-portal-hypertension-in-patients-with-cirrhosis-and-obesity-the-sportdiet-study
#5
Annalisa Berzigotti, Agustín Albillos, Candid Villanueva, Joan Genescá, Alba Ardevol, Salvador Augustín, Jose Luis Calleja, Rafael Bañares, Juan Carlos García-Pagán, Francisco Mesonero, Jaime Bosch
: Obesity increases the risk of clinical decompensation in cirrhosis, possibly by increasing portal pressure. Whether weight reduction can be safely achieved through lifestyle changes (diet and exercise) in overweight/obese patients with cirrhosis, and if weight loss reducesportal pressure in this setting is unknown. This prospective, multicentric, uncontrolled pilot study enrolled patients with compensated cirrhosis, portal hypertension (hepatic venous pressure gradient, HVPG≥ 6mmHg) and body mass index (BMI)≥26 Kg/m2 in an intensive 16-week lifestyle intervention program (personalized hypocaloric normoproteic diet and 60 min/wk of supervised physical activity)...
December 20, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27979668/time-harmonic-elastography-of-the-liver-is-sensitive-to-intrahepatic-pressure-gradient-and-liver-decompression-after-transjugular-intrahepatic-portosystemic-shunt-tips-implantation
#6
Heiko Tzschätzsch, Ingolf Sack, Stephan Rodrigo Marticorena Garcia, Selcan Ipek-Ugay, Jürgen Braun, Bernd Hamm, Christian E Althoff
We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear wave speed (SWS) measured by multi-frequency time-harmonic ultrasound elastography (THE) before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation. Ten patients with ascites, cirrhotic liver disease and portal hypertension were prospectively examined with invasive HVPG measurement and THE before and after TIPS implantation. HVPG and SWS decreased after TIPS placement from 20.4 ± 2.2 mmHg to 9...
December 12, 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27932129/predictors-of-poor-prognosis-in-recurrent-hepatitis-c-after-liver-transplantation
#7
E Berge, E Otón, Z Reina, L Díaz, A Márquez, L Cejas, S Acosta, F Pérez
BACKGROUND: Hepatitis C is a common indication for liver transplantation (LT). Hepatitis C virus (HCV) recurrence is universal in viremic patients. This recurrence is frequently very aggressive, with graft loss in less than 5 years. Our aim is to detect which factors are related to worse fibrosis at 1 year post-LT. PATIENTS AND METHODS: Records of all HCV-positive transplanted patients in Hospital Universitario Nuestra Señora de la Candelaria from 1996 to 2014 were collected...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#8
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
#9
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
#10
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
#11
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
#12
Nina Kimer, Julie Steen Pedersen, Troels Malte Busk, Lise Lotte Gluud, Lise Hobolth, Aleksander Krag, Søren Møller, Flemming Bendtsen
: 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 (clinicaltrials.gov, NCT01769040) investigates the effects of rifaximin on hemodynamics, renal function, and vasoactive hormones. We randomized 54 stable outpatients with cirrhosis and ascites to rifaximin 550 mg twice a day (n = 36) or placebo twice a day (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
#13
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...
2016: Digestion
https://www.readbyqxmd.com/read/27751595/a-meta-analysis-for-the-diagnostic-performance-of-transient-elastography-for-clinically-significant-portal-hypertension
#14
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
#15
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
#16
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
#17
EDITORIAL
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
#18
Jason Y Huang, Jason B Samarasena, Takeshi Tsujino, John Lee, Ke-Qin Hu, Christine E McLaren, Wen-Pin Chen, Kenneth J Chang
BACKGROUND AND 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
#19
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
#20
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
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