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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
#1
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
#2
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
#3
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/29064029/the-portal-hypertension-syndrome-etiology-classification-relevance-and-animal-models
#4
REVIEW
Jaime Bosch, Yasuko Iwakiri
BACKGROUND: Portal hypertension is a key complication of portal hypertension, which is responsible for the development of varices, ascites, bleeding, and hepatic encephalopathy, which, in turn, cause a high mortality and requirement for liver transplantation. AIM: This review deals with the present day state-of-the-art preventative treatments of portal hypertension in cirrhosis according to disease stage. Two main disease stages are considered, compensated and decompensated cirrhosis, the first having good prognosis and being mostly asymptomatic, and the second being heralded by the appearance of bleeding or non-bleeding complications of portal hypertension...
October 24, 2017: Hepatology International
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
#5
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
https://www.readbyqxmd.com/read/28970710/transient-elastography-fibroscan-in-patients-with-non-cirrhotic-portal-fibrosis
#6
Praveen Sharma, Rachit Agarwal, Shashi Dhawan, Naresh Bansal, Vikas Singla, Ashish Kumar, Anil Arora
BACKGROUND: Non-cirrhotic portal hypertension (NCPH) is a common cause of variceal bleed in developing countries. Transient elastography (TE) using Fibroscan is a useful technique for evaluation of fibrosis in patients with liver disease. There is a paucity of studies evaluating TE in patients with Non-cirrhotic portal fibrosis (NCPF) and none in Asian population. Aim of this study was to evaluate role of TE in NCPF. METHODS: Retrospective data of consecutive patients of NCPF as per Asian pacific association for the study of liver (APASL) guidelines were noted...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28960366/portal-pressure-and-liver-stiffness-measurements-in-the-prediction-of-fibrosis-regression-after-svr-in-recurrent-hepatitis-c
#7
Ezequiel Mauro, Gonzalo Crespo, Carla Montironi, Maria-Carlota Londoño, Virginia Hernández-Gea, Pablo Ruiz, Lydia Sastre, Julissa Lombardo, Zoe Mariño, Alba Díaz, Jordi Colmenero, Antoni Rimola, Juan Carlos Garcia-Pagan, Mercé Brunet, Xavier Forns, Miquel Navasa
Sustained virological response (SVR) improves survival in post liver transplant (LT) recurrent hepatitis C. However, the impact of SVR on fibrosis regression is not well defined. In addition, the performance of noninvasive methods to evaluate the presence of fibrosis and portal hypertension after SVR has been scarcely evaluated. We aimed to investigate the degree of fibrosis regression (decrease ≥1 METAVIR stage) after SVR and its associated factors in recurrent hepatitis C, as well as the diagnostic capacity of noninvasive methods in the assessment of liver fibrosis and portal hypertension after viral clearance...
September 27, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28855918/effects-of-a-long-acting-formulation-of-octreotide-on-patients-with-portal-hypertension
#8
Pei-Jing Cui, Jing Yao, Yin Zhu, Zheng-Yun Zhang, Jun Yang
OBJECTIVE: This study aimed to determine whether the treatment of a long-acting formulation of octreotide (OCT-LAR) exerted a similar effect on improving the prognosis of patients with portal hypertension compared with placement of transjugular intrahepatic portosystemic shunts (TIPSs). METHODS: A total of 24 patients with portal hypertension who underwent TIPS placement or OCT-LAR treatment from January 2010 to January 2015 were reviewed. Hemodynamic studies, biological values, live functions, and treatment complications before and during the treatment were evaluated...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28820885/diagnostic-efficacy-of-noninvasive-liver-fibrosis-indexes-in-predicting-portal-hypertension-in-patients-with-cirrhosis
#9
Le Wang, Yuemin Feng, Xiaowen Ma, Guangchuan Wang, Hao Wu, Xiaoyu Xie, Chunqing Zhang, Qiang Zhu
BACKGROUND: Recent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated. AIMS: To evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. METHODS: A total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade...
2017: PloS One
https://www.readbyqxmd.com/read/28752925/management-of-portal-hypertension-before-and-after-liver-transplantation
#10
L W Unger, G Berlakovich, M Trauner, T Reiberger
Orthotopic liver transplantation (OLT) represents a curative treatment option for end-stage liver disease (ESLD). While epidemiology of ESLD has recently changed due the rising prevalence of non-alcoholic fatty liver disease (NAFLD) and decreased burden of hepatitis C virus (HCV) infections due to highly-effective antiviral regimens, the management of portal hypertension (PHT) remains a clinical challenge in the pre- and post-OLT setting. The measurement of hepatic venous pressure gradient (HVPG) represents the most reliable, but invasive tool for assessment of the severity of PHT...
July 28, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28734831/effects-of-all-oral-anti-viral-therapy-on-hvpg-and-systemic%C3%A2-hemodynamics-in-patients-with-hepatitis-c-virus-associated-cirrhosis
#11
Sabela Lens, Edilmar Alvarado-Tapias, Zoe Mariño, María-Carlota Londoño, Elba LLop, Javier Martinez, Jose Ignacio Fortea, Luís Ibañez, Xavier Ariza, Anna Baiges, Adolfo Gallego, Rafael Bañares, Angela Puente, Agustín Albillos, Jose Luís Calleja, Xavier Torras, Virginia Hernández-Gea, Jaume Bosch, Cándid Villanueva, Xavier Forns, Juan Carlos García-Pagán
BACKGROUND & AIMS: Patients with hepatitis C virus-associated cirrhosis and clinical significant portal hypertension (CSPH, hepatic venous pressure gradient [HVPG] 10 mmHg or greater), despite achieving sustained virological response (SVR) to therapy, remain at risk of liver decompensation. We investigated hemodynamic changes following SVR in patients with CSPH and whether liver stiffness measurements (LSMs) can rule out the presence of CSPH. METHODS: We performed a multicenter prospective study of 226 patients with hepatitis C virus-associated cirrhosis and CSPH who had SVR to interferon-free therapy at 6 Liver Units in Spain...
November 2017: Gastroenterology
https://www.readbyqxmd.com/read/28681347/new-concepts-on-the-clinical-course-and-stratification-of-compensated-and-decompensated-cirrhosis
#12
REVIEW
Gennaro D'Amico, Alberto Morabito, Mario D'Amico, Linda Pasta, Giuseppe Malizia, Paola Rebora, Maria Grazia Valsecchi
The clinical course of cirrhosis has been typically described by a compensated and a decompensated state based on the absence or, respectively, the presence of any of bleeding, ascites, encephalopathy or jaundice. More recently, it has been recognized that increasing portal hypertension and several major clinical events are followed by a marked worsening in prognosis, and disease states have been proposed accordingly in a multistate model. The development of multistate models implies the assessment of the probabilities of more than one possible outcome from each disease state...
July 5, 2017: Hepatology International
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
#13
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...
September 15, 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
#14
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...
August 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28565796/hemodynamic-effects-of-renin-angiotensin-aldosterone-inhibitor-and-%C3%AE-blocker-combination-therapy-vs-%C3%AE-blocker-monotherapy-for-portal-hypertension-in-cirrhosis-a-meta-analysis
#15
Jianrong Wang, Wenxia Lu, Jingjing Li, Rong Zhang, Yuqing Zhou, Qin Yin, Yuanyuan Zheng, Fan Wang, Yujing Xia, Kan Chen, Sainan Li, Tong Liu, Jie Lu, Yingqun Zhou, Chuan-Yong Guo
β-blockers are commonly used for the treatment of acute variceal bleeding in cirrhosis. Renin-angiotensin-aldosterone antagonists (angiotensin I-converting enzyme inhibitors, angiotensin receptor blockers and aldosterone antagonists) are potential therapies for portal hypertension. Several studies have compared the renin-angiotensin-aldosterone system (RAAS) inhibitor and β-blocker combination therapy vs. β-blocker monotherapy, with inconsistent results. The aim of the present study was to assess the efficacy of the RAAS inhibitor and β-blocker combination therapy vs...
May 2017: Experimental and Therapeutic Medicine
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
#16
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
#17
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...
November 2017: Abdominal Radiology
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
#18
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
#19
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/28263953/transient-elastography-versus-hepatic-venous-pressure-gradient-for-diagnosing-portal-hypertension-a-systematic-review-and-meta-analysis
#20
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
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