Liver stiffness: a novel parameter for the diagnosis of liver disease

Mueller, Sebastian

doi:10.2147/hmer.s7394

Cited by 328 publications

(323 citation statements)

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“…A previous study that assessed TE considering liver biopsy as a reference method, demonstrated that LS is a sum of fibrosis and inflammation, and that it also might be influenced by liver steatosis [15]. There are also several confounding factors that can lead to higher LS values which might overestimate fibrosis: sinusoidal pressure [16], inflammation, as suggested by high aminotransferase levels [17,18], extrahepatic cholestasis [19], liver congestion due to heart failure [20]. The influence of inflammation can be supported by the observation that LS decreases in patients with alcoholic liver disease following alcohol withdrawal [21], and also in patients with chronic hepatitis C following HCV clearance [22 -24].…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of Liver Stiffness Values by means of Transient Elastography in Patients with HCV Liver Cirrhosis undergoing Interferon Free Treatment

Sporea

Lupușoru

Mare

et al. 2017

JGLD

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Background & Aims: Liver stiffness (LS) measurement by Transient Elastography (TE) has been widely accepted as a tool for fibrosis assessment. The aim of this study was to assess LS dynamics in a group of patients with HCV liver cirrhosis after interferon free treatment (IFT).Methods: This two-center clinical trial included 225 patients with compensated HCV cirrhosis (all genotype 1b), who received IFT for 12 weeks. All patients were evaluated by means of TE at the beginning and at the end of treatment (EOT), and a subgroup (170 patients) also 12 weeks after EOT; all of them had sustained viral response (SVR). Reliable LS measurements (LSM) were defined as a median value of 10 valid LSM, with IQR <30% and SR ≥60%. Both M and XL probes were used. For diagnosing cirrhosis we used a cut-off value of 12kPa as proposed by the Tsochatzis meta-analysis. We considered a decrease or increase of more than 10% in LSM as being significant.Results: Out of 225 subjects, reliable measurements were obtained in 93.7%, so that the final analysis included 211 patients. The mean LS values decreased significantly after IFT: 26.4±11.7 vs. 23.5±13.3 kPa (p=0.01). Most patients, 59.2% (125/211) presented more than 10% decrease in LS values, 24.1% (51/211) had stable LS values, while in 16.4% (35/211) cases, the LS values increased. In the subgroup of 170 patients with LSM also performed 12 weeks after EOT (SVR), the mean LS values were significantly lower as compared to baseline: 21.3±11 kPa vs. 27.4±11.9 kPa (p<0.0001) and also as compared to EOT: 21.3±11 kPa vs. 23.7±13.3 kPa (p<0.0001).Conclusion: In our patients with HCV liver cirrhosis, the mean LS values evaluated by TE significantly decreased after antiviral treatment at EOT and also 12 weeks after EOT as compared to baseline. Overall, about 60% of patients had LS values at EOT lower than at baseline, while 12 weeks after EOT about 75% of patients had LS values lower than at baseline. –.Abbreviations: APRI: aspartate aminotransferase platelet ratio index; BMI: body mass index; DAA: direct acting agents; EOT: end of treatment; FIB-4: fibrosis 4; HBV: hepatitis B virus; HCV: hepatitis C virus; IFT: interferon free treatment; IQR: interquartile range; LS: liver stiffness; LSM: liver stiffness measurements; SR: success rate; SVR: sustained viral response; TE: Transient Elastography.

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Section: Introductionmentioning

confidence: 99%

“…The diuretic treatment in patients with congestive heart failure leads to a decrease in LS values [20]. Many other factors may also increase LS such as hepatic infiltration with tumor cells, inflammatory cells, mastocytosis or amyloidosis [18].…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Liver Stiffness Values by means of Transient Elastography in Patients with HCV Liver Cirrhosis undergoing Interferon Free Treatment

Sporea

Lupușoru

Mare

et al. 2017

JGLD

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show abstract

“…A study from Sakata (Sakata et al 2004) supports the pressure-matrix-stiffness sequence hypothesis (Mueller & Sandrin 2010). Under this hypothesis, pressure results in increased mechanical stretching which induces transforming growth factor (TGF)-β synthesis in hepatic stellate cells, which is known to be highly expressed under profibrogenic conditions.…”

Section: Molecular Mechanismmentioning

confidence: 91%

Non-Invasive Assessment of Liver Fibrosis by Vibration-Controlled Transient Elastography (Fibroscan®)

Sandrin¹,

Oudry²,

Bastard³

et al. 2011

Liver Biopsy

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“…6,7 Most clinical data on LS have been obtained with TE (FibroScan), which was the first technique to be introduced and is the most widely used. However, no Food and Drug Administration approval exists yet for the United States.…”

Section: Assessment Of the Fibrosis Stage Via Lsmentioning

confidence: 99%

“…Finally, LS highly correlates with portal pressure, and esophageal varices and HCC are likely at values > 20 kPa. 6,7 Several clinically relevant conditions, such as inflammation, liver congestion, or mechanic cholestasis may increase LS in the absence of fibrosis (Fig. 2).…”

Section: Assessment Of the Fibrosis Stage Via Lsmentioning

confidence: 99%