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Hepatic venous pressure gradient

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https://www.readbyqxmd.com/read/29399280/collagen-proportionate-area-correlates-to-hepatic-venous-pressure-gradient-in-non-abstinent-cirrhotic-patients-with-alcoholic-liver-disease
#1
Sophie Restellini, Nicolas Goossens, Sophie Clément, Nicolas Lanthier, Francesco Negro, Laura Rubbia-Brandt, Laurent Spahr
AIM: To explore the relationship between collagen proportionate area (CPA) and portal hypertension-related clinical manifestations in alcoholic liver disease (ALD). METHODS: Retrospective study with chart review of patients with ALD adressed to our center between January 2012 and December 2013 for a transjugular liver biopsy (TJLB) and hepatic hemodynamic study. Patients were included if they met the following criteria: (1) Medical indication for a liver biopsy in the setting of ALD; (2) recent (< 15 d) clinical, radiological, endoscopic and biological data available; and (3) estimated follow-up of at least 6 mo...
January 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/29377193/von-willebrand-factor-indicates-bacterial-translocation-inflammation-and-procoagulant-imbalance-and-predicts-complications-independently-of-portal-hypertension-severity
#2
M Mandorfer, P Schwabl, R Paternostro, K Pomej, D Bauer, J Thaler, C Ay, P Quehenberger, M Fritzer-Szekeres, M Peck-Radosavljevic, M Trauner, T Reiberger, A Ferlitsch
BACKGROUND: Elevated plasma von Willebrand factor antigen (vWF) has been shown to indicate the presence of clinically significant portal hypertension, and thus, predicts the development of clinical events in patients with cirrhosis. AIM: To investigate the impact of bacterial translocation and inflammation on vWF, as well as the association between vWF and procoagulant imbalance. Moreover, we assessed whether vWF predicts complications of cirrhosis, independent of the severity of portal hypertension...
January 29, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29331339/cardiopulmonary-hemodynamics-and-c-reactive-protein-as-prognostic-indicators-in-compensated-and-decompensated-cirrhosis
#3
Laura Turco, Guadalupe Garcia-Tsao, Ilenia Magnani, Marcello Bianchini, Martina Costetti, Cristian Caporali, Stefano Colopi, Emilio Simonini, Nicola De Maria, Federico Banchelli, Rosario Rossi, Erica Villa, Filippo Schepis
BACKGROUND AND AIMS: The main stages of cirrhosis (compensated and decompensated) have been substaged based on clinical, endoscopic, and portal pressure (determined by the hepatic venous pressure gradient, HVPG) features. Vasodilatation leading to a hyperdynamic circulatory state is central in the development of a late decompensated stage with inflammation being currently considered a key driver. We aimed to assess hepatic/systemic hemodynamics and inflammation (by C reactive protein, CRP) among the different substages of cirrhosis and to investigate their interrelationship and prognostic relevance...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29322599/non-invasive-evaluation-of-portal-hypertension-using-shear-wave-elastography-analysis-of-two-algorithms-combining-liver-and-spleen-stiffness-in-191-patients-with-cirrhosis
#4
L Elkrief, M Ronot, F Andrade, M Dioguardi Burgio, T Issoufaly, M Zappa, O Roux, J Bissonnette, A Payancé, D Lebrec, C Francoz, O Soubrane, D Valla, F Durand, V Vilgrain, L Castera, P-E Rautou
BACKGROUND: Two algorithms based on sequential measurements of liver and spleen stiffness using two-dimensional shearwave elastography (2D-SWE) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] ≥10 mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy. AIM: To validate externally these algorithms in a large cohort of patients with cirrhosis. METHODS: One hundred and ninety-one patients with stable cirrhosis (Child-Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D-SWE at the time of HVPG measurement were included...
January 11, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29316565/transjugular-intrahepatic-portosystemic-shunt-in-patients-with-portal-hypertension-patency-depends-on-coverage-and-interventionalist-s-experience
#5
Matthias Buechter, Paul Manka, Guido Gerken, Ali Canbay, Sandra Blomeyer, Axel Wetter, Jens Altenbernd, Alisan Kahraman, Jens M Theysohn
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice in decompensated portal hypertension. TIPS revision due to thrombosis or stenosis increases morbidity and mortality. Our aim was to investigate patient- and procedure-associated risk factors for TIPS-revision. PATIENTS AND METHODS: We retrospectively evaluated 189 patients who underwent the TIPS procedure. Only patients who required TIPS revision within 1 year (Group I, 34 patients) and patients who did not require re-intervention within the first year (Group II [control group], 54 patients) were included...
January 9, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29290659/balloon-dilatation-for-treatment-of-hepatic-venous-outflow-obstruction-following-pediatric-liver-transplantation
#6
Zhi-Yuan Zhang, Long Jin, Guang Chen, Tian-Hao Su, Zhi-Jun Zhu, Li-Ying Sun, Zhen-Chang Wang, Guo-Wen Xiao
AIM: To assess the efficacy and safety of balloon dilatation for the treatment of hepatic venous outflow obstruction (HVOO) following pediatric liver transplantation. METHODS: A total of 246 pediatric patients underwent liver transplantation at our hospital between June 2013 and September 2016. Among these patients, five were ultimately diagnosed with HVOO. Seven procedures (two patients underwent two balloon dilatation procedures) were included in this analysis...
December 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29274906/aptr-is-a-prognostic-marker-in-cirrhotic-patients-with-portal-hypertension-during-tips-procedure
#7
Shanshan Yu, Yanhua Qi, Jue Jiang, Hua Wang, Qi Zhou
Portal hypertension is a major cause of mortality and morbidity in cirrhotic patients. In this study, we aimed to analyze the clinical characteristics of Alu-mediated p21 transcriptional regulator (APTR) during transjugular intrahepatic portosystemic shunt (TIPS) procedure. Portal and hepatic venous blood was drawn from 84 patients with liver cirrhosis and portal hypertension before and after TIPS treatment. Then, we detected biochemical, hemodynamic parameters and APTR expression before and after TIPS treatment...
March 1, 2018: Gene
https://www.readbyqxmd.com/read/29259380/clinical-value-of-liver-and-spleen-shear-wave-velocity-in-predicting-the-prognosis-of-patients-with-portal-hypertension
#8
Yan Zhang, Da-Feng Mao, Mei-Wu Zhang, Xiao-Xiang Fan
AIM: To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension, and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension. METHODS: All 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29246174/changes-of-liver-hemodynamic-and-elastography-parameters-in-patients-with-colorectal-liver-metastases-receiving-preoperative-chemotherapy-a-note-of-caution
#9
Amalia Pelegrina, Josep Martí, Rosa Miquel, Joana Ferrer, Virginia Hernández-Gea, Alba Diaz, Cristina Nadal, Juan Carlos García-Valdecasas, Josep Fuster
BACKGROUND: New systemic chemotherapy agents have improved prognosis in patients with colorectal liver metastases (CLM), but some of them damage the liver parenchyma and ultimately increase postoperative morbidity and mortality after liver resection. The aims of our study were to determine the degree of hemodynamic and pathological liver injury in CLM patients receiving preoperative chemotherapy and to identify an association between these injuries and postoperative complications after liver resection...
December 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29245324/clinical-efficacy-of-transjugular-intrahepatic-portosystemic-shunt-in-the-treatment-of-hepatopulmonary-syndrome
#10
Hongwei Zhao, Fuquan Liu, Zhendong Yue, Lei Wang, Zhenhua Fan, Fuliang He
Transjugular intrahepatic portosystemic shunt (TIPS) reduces the portal venous pressure of patients with hepatopulmonary syndrome (HPS).To describe the patients who underwent TIPS for the treatment of HPS.A retrospective study was performed on 81 patients with HPS and gastrointestinal hemorrhage treated with TIPS. Thirty patients underwent TIPS through the main portal vein (group A), 24 through the left branch of the portal vein (group B), and 27 through the right branch of the portal vein (group C). The partial pressure of arterial oxygen (PaO2), alveolar-to-arterial oxygen partial pressure gradient (A-aPO2), oxygen saturation (SO2), and complications were recorded and compared...
December 2017: Medicine (Baltimore)
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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