Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis

Ripoll, Cristina; Groszmann, Roberto J.; García–Tsao, Guadalupe; Grace, Norman D.; Burroughs, Andrew K.; Planas, Ramón; Escorsell, Àngels; García‐Pagán, Juan Carlos; Makuch, Robert W.; Patch, David; Matloff, Daniel S.; Bosch, Jaime

doi:10.1053/j.gastro.2007.05.024

Cited by 962 publications

(795 citation statements)

References 13 publications

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“…Although retrospective and conducted in a single centre, this study provided the first ''proof of concept'' that liver stiffness values may have prognostic value in a context of cirrhosis. In addition, several studies [78,79] have shown a correlation between liver stiffness values and portal hypertension diagnosed by means of hepatic venous pressure gradient (HVPG) measurement, the gold standard for the diagnosis and staging of portal hypertension and a reliable predictor of clinical decompensation [80]. A correlation between liver stiffness values and the presence of esophageal varices has also been reported [79,[81][82][83][84].…”

Section: Monitoring Of Disease Progressionmentioning

confidence: 93%

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Castéra

2011

Hepatol Int

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Section: Monitoring Of Disease Progressionmentioning

confidence: 93%

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Castéra

2011

Hepatol Int

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“…Mortality rates related to variceal bleeding are not significant in cirrhotic Child-Pugh Class A or B patients, while it is over 30% in Child-Pugh Class C [25]. There is a higher likelihood of mortality in those patients with active bleeding during endoscopy, in those with advanced cirrhosis (Child-Pugh Class C or a Model for End-Stage Liver Disease (MELD) score of N20), extra-hepatic organ failure, and high HVPG (N 20 mmHg) [28].…”

Section: Varices and Bleedingmentioning

confidence: 99%

Clinical implications of the hyperdynamic syndrome in cirrhosis

Licata

Mazzola

Ingrassia

et al. 2014

European Journal of Internal Medicine

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The hyperdynamic syndrome is a late consequence of portal hypertension in cirrhosis. The principal hemodynamic manifestations of the hyperdynamic syndrome are high cardiac output, and increased heart rate and total blood volume, accompanied by reduced total systemic vascular resistance. Pathophysiology involves a complex of humoral and neural mechanisms that can determine hemodynamic changes, and lead to hyperdynamic circulation. In this review we focus our attention on the manifestations of the hyperdynamic syndrome. Some of these are well described and directly related to portal hypertension (varices, ascites, hepatic encephalopathy, and hepatorenal syndrome), while others, such as hepatopulmonary syndrome, portopulmonary hypertension, and cirrhotic cardiomyopathy, are less known as clinical manifestations related to cirrhosis and, therefore, merit further investigation.

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“…77 In fact, a recent study confirmed HVPG as the best predictor of mortality in cirrhotic patients with compensated Child's A cirrhosis. 78 Yet the shortcomings of traditional study design and technologies highlight the need for the identification of new biomarkers or imaging techniques that allow an exact assessment of the degree of fibrosis and, more important, of the dynamic processes of fibrogenesis or fibrolysis, in order to predict fibrosis progression or to monitor the effect of antifibrotic therapies.…”

Section: Noninvasive Means To Assess Liver Fibrosis and Fibrogenesismentioning

confidence: 99%

Targeting liver fibrosis: Strategies for development and validation of antifibrotic therapies

2009

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We have made striking progress in our understanding of the biochemistry and cell biology that underlies liver fibrosis and cirrhosis, including the development of strategies and agents to prevent and reverse fibrosis. However, translation of this knowledge into clinical practice has been hampered by (1) the limitation of many in vitro and in vivo models to confirm mechanisms and to test antifibrotic agents, and (2) the lack of sensitive methodologies to quantify the degree of liver fibrosis and the dynamics of fibrosis progression or reversal in patients. Furthermore, whereas cirrhosis and subsequent decompensation are accepted hard clinical endpoints, fibrosis and fibrosis progression alone are merely plausible surrogates for future clinical deterioration. In this review we focus on an optimized strategy for preclinical antifibrotic drug development and highlight the current and future techniques that permit noninvasive assessment and quantification of liver fibrosis and fibrogenesis. The availability of such noninvasive methodologies will serve as the pacemaker for the clinical development and validation of potent antifibrotic agents. (HEPATOLOGY 2009;50:1294-1306

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Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis

Cited by 962 publications

References 13 publications

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Clinical implications of the hyperdynamic syndrome in cirrhosis

Targeting liver fibrosis: Strategies for development and validation of antifibrotic therapies

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