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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/28017842/measurement-of-spleen-stiffness-with-acoustic-radiation-force-impulse-imaging-predicts-mortality-and-hepatic-decompensation-in-patients-with-liver-cirrhosis
#2
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
#3
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
#4
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/27990835/influence-of-sustained-viral-response-on-the-regression-of-fibrosis-and-portal-hypertension-in-cirrhotic-hcv-patients-treated-with-antiviral-triple-therapy
#5
Ángela Puente, Joaquín Cabezas, María Jesús López Arias, 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)...
December 19, 2016: 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
#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/27910154/interferon-free-regimens-improve-portal-hypertension-and-histological-necroinflammation-in-hiv-hcv-patients-with-advanced-liver-disease
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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/27746613/hemodynamic-response-to-carvedilol-is-maintained-for-long-periods-and-leads-to-better-clinical-outcome-in-cirrhosis-a-prospective-study
#13
Vijendra Kirnake, Anil Arora, Varun Gupta, Praveen Sharma, Vikas Singla, Naresh Bansal, Mohan Goyal, Romesh Chawlani, Ashish Kumar
BACKGROUND: Non-selective beta-blockers (NSBBs), e.g. propranolol, are recommended for prophylaxis of variceal bleeding in cirrhosis. Carvedilol, a newer NSBB with additional anti-α1-adrenergic activity, is superior to propranolol in reducing portal pressure. Repeated HVPG measurements are required to identify responders to NSBB. We aimed to determine whether a single-time HVPG measurement, using acute-hemodynamic-response-testing, is sufficient to predict long-term response to carvedilol, and whether these responders have better clinical outcome...
September 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27663418/non-invasive-estimation-of-hvpg-by-combined-structural-and-hemodynamic-evaluation-of-portal-hypertension-using-quantitative-magnetic-resonance-imaging
#14
EDITORIAL
Sudhakar Kundapur Venkatesh, Rohit Loomba
No abstract text is available yet for this article.
December 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27661973/prognostic-significance-of-hemodynamic-and-clinical-stages-in-the-prediction-of-hepatocellular-carcinoma
#15
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/27639071/noninvasive-tools-and-risk-of-clinically-significant-portal-hypertension-and-varices-in-compensated-cirrhosis-the-anticipate-study
#16
Juan G Abraldes, Christophe Bureau, Horia Stefanescu, Salvador Augustin, Michael Ney, Hélène Blasco, Bogdan Procopet, Jaime Bosch, Joan Genesca, Annalisa Berzigotti
: In patients with compensated advanced chronic liver disease (cACLD), the presence of clinically significant portal hypertension (CSPH) and varices needing treatment (VNT) bears prognostic and therapeutic implications. Our aim was to develop noninvasive tests-based risk prediction models to provide a point-of-care risk assessment of cACLD patients. We analyzed 518 patients with cACLD from five centers in Europe/Canada with paired noninvasive tests (liver stiffness measurement [LSM] by transient elastography, platelet count, and spleen diameter with calculation of liver stiffness to spleen/platelet score [LSPS] score and platelet-spleen ratio [PSR]) and endoscopy/hepatic venous pressure gradient measurement...
September 17, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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
#17
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
#18
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/27569696/shear-wave-elastography-of-the-liver-and-spleen-identifies-clinically-significant-portal-hypertension-a-prospective-multi-center-study
#19
Christian Jansen, Christopher Bogs, Wim Verlinden, Maja Thiele, Philipp Möller, Jan Görtzen, Jennifer Lehmann, Thomas Vanwolleghem, Luisa Vonghia, Michael Praktiknjo, Johannes Chang, Aleksander Krag, Christian P Strassburg, Sven Francque, Jonel Trebicka
BACKGROUND AND AIMS: Clinically significant portal hypertension (CSPH) is associated with severe complications and decompensation of liver cirrhosis. Liver stiffness measured either by transient elastography (TE) or Shear-wave elastography (SWE) and spleen stiffness by TE might be helpful in the diagnosis of CSPH. We recently showed the algorithm to rule-out CSPH by using sequential liver- (L-SWE) and spleen-Shear-wave elastography (S-SWE). This study investigated the diagnostic value of S-SWE for diagnosis of CSPH...
August 29, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27566593/hvpg-signature-a-prognostic-and-predictive-tool-in-hepatocellular-carcinoma
#20
REVIEW
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...
September 20, 2016: Oncotarget
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