Liver Stiffness by Transient Elastography to Detect Porto‐Sinusoidal Vascular Liver Disease With Portal Hypertension

Elkrief, Laure; Lazareth, Marie; Chevret, Sylvie; Paradis, Valérie; Magaz, Marta; Blaise, Lorraine; Rubbia‐Brandt, Laura; Moga, Lucile; Durand, François; Payancé, Audrey; Plessier, Aurélie; Chaffaut, Cendrine; Valla, Dominique; Malphettes, Marion; Díaz, Alba; Nault, Jean‐Charles; Nahon, Pierre; Audureau, Étienne; Ratziu, Vlad; Castéra, Laurent; Pagan, Juan‐Carlos Garcia; Ganne‐Carrié, Nathalie; Rautou, Pierre‐Emmanuel

doi:10.1002/hep.31688

Cited by 52 publications

(54 citation statements)

References 49 publications

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“…In Elkrief et al's study, the cutoff values of 10 and 20 kPa were found to have sufficient sensitivity and specificity, respectively, in distinguishing the two [107]. For example, liver stiffness values lower than 10 kPa were highly suggestive of INCPH/ PSVD in patients with signs of PH whereas levels exceeding 20 kPa effectively excluded the disease [107]. Additionally, hepatic venography shows frequent veno-venous shunts in IN-CPH/PSVD with narrower angles between the large veins and their branches when compared to cirrhosis [108].…”

Section: Radiologic Featuresmentioning

confidence: 90%

“…INCPH/PSVD has significantly lower mean liver stiffness compared to that of cirrhosis. In Elkrief et al's study, the cutoff values of 10 and 20 kPa were found to have sufficient sensitivity and specificity, respectively, in distinguishing the two [107]. For example, liver stiffness values lower than 10 kPa were highly suggestive of INCPH/ PSVD in patients with signs of PH whereas levels exceeding 20 kPa effectively excluded the disease [107].…”

Section: Radiologic Featuresmentioning

confidence: 94%

“…Data on liver stiffness measurement (via transient elastography) are limited in INCPH/PSVD. However, recent studies have shown that it can be useful in distinguishing INCPH/ PSVD from cirrhosis [32,33,107]. INCPH/PSVD has significantly lower mean liver stiffness compared to that of cirrhosis.…”

Section: Radiologic Featuresmentioning

confidence: 99%

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Idiopathic Non-Cirrhotic Portal Hypertension and Porto-Sinusoidal Vascular Disease: Review of Current Data

et al. 2021

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Idiopathic non-cirrhotic portal hypertension (INCPH) is a clinicopathologic disease entity characterized by the presence of clinical signs and symptoms of portal hypertension (PH) in the absence of liver cirrhosis or known risk factors accountable for PH. Multiple hematologic, immune-related, infectious, hereditary and metabolic risk factors have been associated with this disorder. Still, the exact etiopathogenesis is largely unknown. The recently proposed portosinusoidal vascular disease (PSVD) scheme broadens the spectrum of the disease by also including patients without clinical PH who are found to have similar histopathologic findings on core liver biopsies. Three histomorphologic lesions have been identified as specific for PSVD to include obliterative portal venopathy, nodular regenerative hyperplasia and incomplete septal cirrhosis/fibrosis. However, these findings are often subtle, under-recognized and subjective with low interobserver agreement among pathologists. Additionally, the natural history of the subclinical forms of the disease remains unexplored. The clinical course is more favorable compared to cirrhosis patients, especially in the absence of clinical PH or liver dysfunction. There are no universally accepted guidelines in regard to diagnosis and treatment of INCPH/PSVD. Hence, this review emphasizes the need to raise awareness of this entity by highlighting its complex pathophysiology and clinicopathologic associations. Lastly, formulation of standardized diagnostic criteria with clinical validation is necessary to avoid misclassifying vascular diseases of the liver and to develop and implement targeted therapeutic strategies.

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Section: Radiologic Featuresmentioning

confidence: 90%

Section: Radiologic Featuresmentioning

confidence: 94%

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Idiopathic Non-Cirrhotic Portal Hypertension and Porto-Sinusoidal Vascular Disease: Review of Current Data

et al. 2021

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“…The natural history of disease progression in NAFLD is highly variable, e.g. in the placebo group of the CENTAUR study (cenicriviroc, a dual CCR2/CCR5 antagonist) the fibrosis response worsened for those who initially improved between the first and second year and vice versa for those who initially worsened after the first year [ 9 ]. While most patients have mild steatosis, approximately 20–30% of cases develop NASH with progressive fibrosis, and of those, approximately 20% will progress to cirrhosis with an increased risk of hepatocellular carcinoma [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

NAFLD and cardiovascular diseases: a clinical review

et al. 2020

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Non-alcoholic fatty liver DISEASE (NAFLD) is the most common chronic liver disease in Western countries and affects approximately 25% of the adult population. Since NAFLD is frequently associated with further metabolic comorbidities such as obesity, type 2 diabetes mellitus, or dyslipidemia, it is generally considered as the hepatic manifestation of the metabolic syndrome. In addition to its potential to cause liver-related morbidity and mortality, NAFLD is also associated with subclinical and clinical cardiovascular disease (CVD). Growing evidence indicates that patients with NAFLD are at substantial risk for the development of hypertension, coronary heart disease, cardiomyopathy, and cardiac arrhythmias, which clinically result in increased cardiovascular morbidity and mortality. The natural history of NAFLD is variable and the vast majority of patients will not progress from simple steatosis to fibrosis and end stage liver disease. However, patients with progressive forms of NAFLD, including non-alcoholic steatohepatitis (NASH) and/or advanced fibrosis, as well as NAFLD patients with concomitant types 2 diabetes are at highest risk for CVD. This review describes the underlying pathophysiological mechanisms linking NAFLD and CVD, discusses the role of NAFLD as a metabolic dysfunction associated cardiovascular risk factor, and focuses on common cardiovascular manifestations in NAFLD patients.

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“…We read with great interest the letter by Valsan et al commenting on our recent article on liver stiffness measurement using transient elastography (TE‐LSM) in patients with portosinusoidal vascular liver disease (PSVD). ( 1 )…”

Section: Figmentioning

confidence: 99%