scholarly journals Prognostic Markers in Patients with Cirrhosis and Portal Hypertension Who Have Not Bled

2011 ◽  
Vol 31 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Maria Poca ◽  
Angela Puente ◽  
Isabel Graupera ◽  
Càndid Villanueva
Keyword(s):  
Portal Hypertension ◽  
Prognostic Value ◽  
Prognostic Markers ◽  
Transient Elastography ◽  
Serum Markers ◽  
Promising Technique ◽  
Prognostic Information ◽  
Compensated Cirrhosis ◽  
Clinically Significant ◽  
Complications Of Cirrhosis

Prognostic markers of compensated cirrhosis should mainly investigate factors involved with progression to decompensation because death in cirrhosis is related with decompensation. Portal hypertension plays a crucial role in the pathophysiology of most complications of cirrhosis. Accordingly, HVPGmonitoring has strong prognostic value. An HVPG ≥ 10 mmHg determines a significantly higher risk of developing decompensation. Esophageal varices also can develop when the HVPG is ≥ 10 mmHg, although an HVPG ≥ 12 mmHg is required for variceal bleeding to occur. Monitoring the changes induced by the treatment of portal hypertension on HVPG, provides strong prognostic information. In compensated cirrhosis hemodynamic response is appropriate when the HVPG decreased to <10 mmHg or by > 10% from baseline, because the incidence of complications such as bleeding or ascites significantly decrease when these targets are achieved. Whether serum markers, such as the FibroTest, they, may be valuable to predict decompensation should be established. Transient Elastography is a promising technique that has shown an excellent accuracy to detect severe portal hypertension. However, whether it can adequately determine clinically significant portal hypertension, and risk of developing varices and decompensation, should be established. Magnetic Resonance Elastography is also promising.

scholarly journals Noninvasive Evaluation of Portal Hypertension Using a Supervised Learning Technique

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Mindaugas Marozas ◽  
Romanas Zykus ◽  
Andrius Sakalauskas ◽  
Limas Kupčinskas ◽  
Arūnas Lukoševičius
Keyword(s):  
Portal Hypertension ◽  
Supervised Learning ◽  
Evaluation Method ◽  
Clinical Laboratory ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Noninvasive Evaluation ◽  
Noninvasive Methods ◽  
Supervised Learning Algorithms ◽  
Clinically Significant

Portal hypertension (PHT) is a key event in the evolution of different chronic liver diseases and leads to the morbidity and mortality of patients. The traditional reliable PHT evaluation method is a hepatic venous pressure gradient (HVPG) measurement, which is invasive and not always available or acceptable to patients. The HVPG measurement is relatively expensive and depends on the experience of the physician. There are many potential noninvasive methods to predict PHT, of which liver transient elastography is determined to be the most accurate; however, even transient elastography lacks the accuracy to be a perfect noninvasive diagnostic method of PHT. In this research, we are focusing on noninvasive PHT assessment methods that rely on selected best-supervised learning algorithms which use a wide set of noninvasively obtained data, including demographical, clinical, laboratory, instrumental, and transient elastography measurements. In order to build the best performing classification meta-algorithm, a set of 21 classification algorithms have been tested. The problem was expanded by selecting the best performing clinical attributes using algorithm-specific filtering methods that give the lowest error rate to predict clinically significant PHT. The suggested meta-algorithm objectively outperforms other methods found in literature and can be a good substitute for invasive PHT evaluation methods.

Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The “Anticipate” study

Hepatology ◽  
2016 ◽  
Vol 64 (6) ◽  
pp. 2173-2184 ◽  
Author(s):  
Juan G. Abraldes ◽  
Christophe Bureau ◽  
Horia Stefanescu ◽  
Salvador Augustin ◽  
Michael Ney ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Compensated Cirrhosis ◽  
Clinically Significant

Comparison of transient elastography, serum markers and clinical signs for the diagnosis of compensated cirrhosis

2010 ◽  
Vol 25 (9) ◽  
pp. 1562-1568 ◽  
Author(s):  
Raza Malik ◽  
Michelle Lai ◽  
Amama Sadiq ◽  
Rory Farnan ◽  
Shruti Mehta ◽  
...  
Keyword(s):  
Transient Elastography ◽  
Clinical Signs ◽  
Serum Markers ◽  
Compensated Cirrhosis

Assessment of portal hypertension by transient elastography in patients with compensated cirrhosis and potentially resectable liver tumors

2012 ◽  
Vol 56 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Elba Llop ◽  
Annalisa Berzigotti ◽  
Maria Reig ◽  
Eva Erice ◽  
Enric Reverter ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Tumors ◽  
Transient Elastography ◽  
Compensated Cirrhosis

Derivation and Validation of a Model to Predict Clinically Significant Portal Hypertension Using Transient Elastography and FIB-4

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bubu A. Banini ◽  
Samarth Patel ◽  
Jonathan W. Yu ◽  
Le Kang ◽  
Christopher Bailey ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Transient Elastography ◽  
Clinically Significant

Su1696 SPLEEN STIFFNESS MEASUREMENTS (SSM) IN THE IDENTIFICATION OF CLINICALLY-SIGNIFICANT PORTAL HYPERTENSION (CSPH) IN PATIENTS WITH COMPENSATED CIRRHOSIS.

2020 ◽  
Vol 158 (6) ◽  
pp. S-1385
Author(s):  
Guillermo A. Ortiz ◽  
Chiara Palumbo ◽  
Mubarak W. Sayyar ◽  
Maya Balakrishnan ◽  
Arpan Mohanty ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Compensated Cirrhosis ◽  
Spleen Stiffness ◽  
Clinically Significant

scholarly journals SVR12 Higher than 97% in GT3 Cirrhotic Patients with Evidence of Portal Hypertension Treated with SOF/VEL without Ribavirin: A Nation-Wide Cohort Study

Cells ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 313 ◽  
Author(s):  
Alessandra Mangia ◽  
Giovanni Cenderello ◽  
Massimiliano Copetti ◽  
Gabriella Verucchi ◽  
Valeria Piazzolla ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Portal Hypertension ◽  
Transient Elastography ◽  
Real Life ◽  
Genotype 3 ◽  
Compensated Cirrhosis ◽  
Advanced Cirrhosis ◽  
Real Life Data ◽  
Single Tablet Regimen ◽  
Cirrhotic Patients

In clinical trials, a sofosbuvir/velpatasvir (SOF/VEL) pangenotypic single-tablet regimen was associated with high sustained virological response (SVR) rates at 12 weeks (SVR12) after the end of treatment, regardless of genotype and fibrosis stage. No real-life data on genotype 3 (GT3) cirrhotic patients with portal hypertension are available. The aim of this study was to assess the effectiveness of SOF/VEL in GT3 cirrhotics with portal hypertension. Patients with GT3 and advanced cirrhosis were treated for 12 weeks with SOF/VEL without ribavirin at five different centers in Italy from June 2017 to August 2018 and their SVR12 was assessed. Of the 227 GT3 cirrhotics evaluated, 205 met the inclusion criteria and 111 had transient elastography results ≥20 KPa. SVR12 was 97.6% (95% CI 94.4–98.9), rates were 99.1% (95% CI 95.7–99.8) in patients with ≥20 KPa and 95.8% (95% CI 89.5–98.3) in those with <20 KPa (p = 0.18). Analyzed by presence of esophageal varices, the SVR12 rates were 98.4% (95% CI 91.4–99.7) and 97.1% (95% CI 92.9–98.9) in patients without and with varices, respectively (p = 1.0). In real life, SOF/VEL GT3 cirrhotic patients with evidence of portal hypertension can achieve SVR12 levels comparable to those of patients without portal hypertension. These SVR12 rates are similar to what is reported in compensated cirrhosis treated within clinical trials.

Risk assessment of clinically significant portal hypertension by means of hepatosplenic volumetry in compensated cirrhosis

2020 ◽  
Vol 73 ◽  
pp. S742
Author(s):  
Mario Romero Cristóbal ◽  
Ana Clemente ◽  
Enrique Ramon Botella ◽  
Olga Ortega ◽  
Elena Velilla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Portal Hypertension ◽  
Compensated Cirrhosis ◽  
Clinically Significant
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