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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
#1
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
#2
Nezam Afdhal, Gregory T Everson, Jose Luis Calleja, Geoffrey W McCaughan, Jaime Bosch, Diana M Brainard, John G McHutchison, Shampa De-Oertel, Di An, Michael Charlton, Rajender K Reddy, Tarik Asselah, Edward Gane, Michael P Curry, Xavier Forns
BACKGROUND&AIMS: 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. METHODS: Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mmHg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period...
March 10, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28263953/transient-elastography-versus-hepatic-venous-pressure-gradient-for-diagnosing-portal-hypertension-a-systematic-review-and-meta-analysis
#3
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 7, 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
#4
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
#5
REVIEW
Annalisa Berzigotti
Portal hypertension (PH) leads to serious complications such as bleeding from gastro-esophageal varices, ascites and porto-systemic encephalopathy in patients with chronic liver disease (CLD). Since the gold-standard methods for assessing PH and its complications (measurement of hepatic venous pressure gradient, HVPG; endoscopy), are invasive expensive and not available at all centers, non-invasive methods have been increasingly investigated in the last 20 years. The present review focuses on the role of ultrasound elastography, a novel group of non-invasive techniques able to measure stiffness in target organs, to identify the presence, severity and risk of complications of PH...
February 13, 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
#6
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/28107286/liver-stiffness-measured-by-shear-wave-elastography-for-evaluating-intra-hepatic-portal-hypertension-in-children
#7
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: 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 two weeks between June 2012 and October 2015. The correlation between LS and HVPG was assessed...
January 20, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28100019/a-randomized-trial-to-assess-whether-portal-pressure-guided-therapy-to-prevent-variceal-rebleeding-improves-survival-in-cirrhosis
#8
Càndid Villanueva, Isabel Graupera, Carles Aracil, Edilmar Alvarado, Josep Miñana, Ángela Puente, Virginia Hernandez-Gea, Alba Ardevol, Oana Pavel, Alan Colomo, Mar Concepción, María Poca, Xavier Torras, Josep M A Reñe, Carlos Guarner
Monitoring the hemodynamic response of portal pressure to drug therapy accurately stratifies the risk of variceal rebleeding. We assessed whether guiding therapy with HVPG-monitoring may improve survival in the prevention of variceal rebleeding. Cirrhotic patients with controlled variceal bleeding were randomized to a HVPG-guided-therapy group (N= 84) or to a control group (N= 86). In both groups, HVPG and acute β-blocker response were evaluated at baseline and HVPG measurements were repeated at 2-4-weeks to determine chronic response...
January 18, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28079667/stage-of-fibrosis-and-portal-pressure-correlation-in-nonalcoholic-steatohepatitis
#9
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/28017842/measurement-of-spleen-stiffness-with-acoustic-radiation-force-impulse-imaging-predicts-mortality-and-hepatic-decompensation-in-patients-with-liver-cirrhosis
#10
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
#11
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...
April 2017: 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
#12
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 (LS) changes (diet and exercise) in overweight/obese patients with cirrhosis, and if weight loss reduces portal pressure in this setting, is unknown. This prospective, multicentric, uncontrolled pilot study enrolled patients with compensated cirrhosis, portal hypertension (hepatic venous pressure gradient [HVPG] ≥6 mm Hg), and body mass index (BMI) ≥26 kg/m(2) in an intensive 16-week LS intervention program (personalized hypocaloric normoproteic diet and 60 min/wk of supervised physical activity)...
April 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27990835/influence-of-sustained-viral-response-on-the-regression-of-fibrosis-and-portal-hypertension-in-cirrhotic-hcv-patients-treated-with-antiviral-triple-therapy
#13
Ángela Puente, Joaquín Cabezas, María Jesús López Arias, José Ignacio Fortea, María Teresa Arias, Ángel Estébanez, Fernando Casafont, Emilio Fábrega, Javier Crespo
BACKGROUND AND AIMS: The regression of liver fibrosis and portal hypertension (PH) and their influence on the natural history of compensated hepatitis C virus (HCV)-related cirrhosis has not been studied previously. Our objective was to evaluate the influence of sustained virologic response (SVR) on the portal pressure gradient (HVPG) and non-invasive parameters of PH and prognostic factors of response. METHODS: Sixteen patients with compensated HCV genotype 1-related cirrhosis with PH (HVPG > 6 mmHg) without beta-blocker therapy were considered as candidates for PEGα2a + RBV + BOC (48 weeks; lead-in and accepted stopping rules)...
January 2017: Revista Española de Enfermedades Digestivas
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
#14
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/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#15
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
#16
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
#17
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...
January 2017: 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
#18
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...
March 2017: Investigative Radiology
https://www.readbyqxmd.com/read/27775818/rifaximin-has-no-effect-on-hemodynamics-in-decompensated-cirrhosis-a-randomized-double-blind-placebo-controlled-trial
#19
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)...
February 2017: 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
#20
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
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