Review
Gastroenterology & Hepatology
Sarah-Louise Gillespie, Timothy P. P. Hanrahan, Don C. C. Rockey, Avik Majumdar, Peter C. C. Hayes
Summary: Advanced chronic liver disease is a growing concern in the UK, leading to premature morbidity and mortality. Portal hypertension is the main cause of complications like ascites, hepatic encephalopathy, and variceal hemorrhage. Non-selective beta blockers (NSBB), particularly carvedilol, have been shown to effectively reduce portal pressure and prevent variceal hemorrhage.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Dominique Thabut, Masatoshi Kudo
Summary: Portal hypertension and hepatocellular carcinoma commonly coexist and their association affects the prognosis of cirrhosis patients. The interplay between these conditions has therapeutic significance in terms of treating HCC and managing PHT complications. The management recommendations for PHT have been revised, with new screening and prophylaxis indications. PHT may limit locoregional therapies and TIPS placement can be considered for HCC patients. New systemic HCC therapies can impact PHT levels and increase the risk of bleeding. Prevention and adequate treatment of PHT complications are important, particularly in advanced HCC cases. This expert opinion discusses specific aspects of managing both conditions, incorporating recent data in the HCC field.
JOURNAL OF HEPATOLOGY
(2023)
Review
Medicine, General & Internal
Tilman Sauerbruch, Martin Hennenberg, Jonel Trebicka, Robert Schierwagen
Summary: Despite vasoconstrictor activation, patients with liver cirrhosis experience hyperdynamic circulatory disturbance. Non-selective beta-blockers have been established as a therapy to lower portal pressure and protect against variceal hemorrhage. The beneficial effect of the alpha and beta receptor blocking medication, carvedilol, and its consequences in liver cirrhosis patients have not been sufficiently investigated.
FRONTIERS IN MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Candid Villanueva, Ferran Torres, Shiv Kumar Sarin, Hasnain Ali Shah, Dhiraj Tripathi, Anna Brujats, Susana G. Rodrigues, Ankit Bhardwaj, Zahid Azam, Peter C. Hayes, Ankur Jindal, Shahab Abid, Edilmar Alvarado, Jaume Bosch, Carvedilol IPD MA Grp, Baveno Cooperation EASL Consortium
Summary: The study evaluated the effectiveness of carvedilol in patients with compensated cirrhosis. The findings from competing-risk time-to-event meta-analysis showed that long-term carvedilol therapy reduced the risk of decompensation of cirrhosis and significantly improved survival in compensated patients with clinically significant portal hypertension.
JOURNAL OF HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Helene Larrue, Gennaro D'Amico, Pol Olivas, Yong Lv, Theresa Bucsics, Marika Rudler, Tilman Sauerbruch, Virginia Hernandez-Gea, Guohong Han, Thomas Reiberger, Dominique Thabut, Jean-Pierre Vinel, Jean-Marie Peron, Juan-Carlos Garcia-Pagan, Christophe Bureau
Summary: Through the analysis of patients with refractory ascites and prevention of variceal rebleeding, it was found that the use of transjugular intrahepatic portosystemic shunt (TIPS) compared to standard of care (SOC) has significant advantages in reducing the incidence of further decompensation events and improving patient survival.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Xiaocen Zhang, Katelin Marie Durham, Alexander Austin Garza, Arvind R. Murali
Summary: PSVD is a newly named condition that represents non-cirrhotic portal hypertension with characteristic histology and the absence of portal vein thrombosis. It is a more inclusive definition than previously recognized idiopathic non-cirrhotic portal hypertension. However, there is limited data available on PSVD patients.
JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Physiology
Nikolaj Worm Orntoft, Michel Ble, Anna Baiges, Jose Ferrusquia, Virginia Hernandez-Gea, Fanny Turon, Marta Magaz, Soren Moller, Holger Jon Moller, Juan Carlos Garcia-Pagan, Henning Gronbaek
Summary: The study found that soluble CD163 and soluble mannose receptor levels are elevated in patients with idiopathic portal hypertension and cirrhosis, but normal in patients with non-cirrhotic portal hypertension. This suggests that hepatic macrophage activation is more driven by the underlying liver disease such as cirrhosis, rather than portal hypertension.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Shuo Zhang, Li Cai, Hui Zhong, Bo Yang, Weiping Song, Haoyu Jia, Shuai Chen, Fengshang Zhu, Jing Li, Changqing Yang
Summary: This study aimed to assess the prognostic significance of virtual portal pressure gradient (vPPG) response to carvedilol in patients with compensated cirrhosis. The results showed that vPPG response was associated with VH, ascites, and overall decompensation events in compensated cirrhosis. Factors such as red color sign and MCP-1 were also significantly correlated with vPPG response. Therefore, vPPG response can be used as a noninvasive tool for predicting disease progression.
HEPATOLOGY RESEARCH
(2023)
Article
Gastroenterology & Hepatology
Karen Vagner Danielsen, Jens Dahlgaard Hove, Puria Nabilou, Meng Yin, Jun Chen, Mirabella Zhao, Thomas Kallemose, Ane Sogaard Teisner, Hartwig Roman Siebner, Richard L. Ehman, Soren Moller, Flemming Bendtsen
Summary: MR elastography can reflect portal hypertension in patients with liver cirrhosis, but the effect of NSBB treatment is significant on spleen stiffness, while inconsistent on liver stiffness. Changes in stiffness cannot predict the effect of NSBB on HVPG.
LIVER INTERNATIONAL
(2021)
Article
Medicine, Research & Experimental
Lili Zhang, Yitong Wang, Wenliang Lv, Jianhua Hu, Chunyan Gou
Summary: This study analyzed the clinical data of five patients with portal hypertension caused by polycythemia vera and summarized the characteristics of this condition to enhance knowledge about the disease.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Elisabetta Degasperi, Maria Paola Anolli, Sara Colonia Uceda Renteria, Dana Sambarino, Marta Borghi, Riccardo Perbellini, Caroline Scholtes, Floriana Facchetti, Alessandro Loglio, Sara Monico, Mirella Fraquelli, Andrea Costantino, Ferruccio Ceriotti, Fabien Zoulim, Pietro Lampertico
Summary: A 48-week course of BLV 2 mg/day monotherapy is safe and effective for patients with HDV-related compensated cirrhosis and CSPH.
JOURNAL OF HEPATOLOGY
(2022)
Article
Acoustics
Yuanqiang Lin, Yan Liu, Bo Jiang, Wenhui Li, Hequn Li, Hui Wang
Summary: This study found that hepatic transit time (HTT) and shear wave velocity (SWV) can be used as indicators for diagnosing cirrhotic portal hypertension, with no significant difference in diagnostic efficacy between the two. HTT is more meaningful for assessing changes in portal pressure.
ULTRASOUND IN MEDICINE AND BIOLOGY
(2021)
Review
Medicine, General & Internal
Hitoshi Maruyama, Maki Tobari, Hiroaki Nagamatsu, Suichiro Shiina, Tadashi Yamaguchi
Summary: Portal hypertension is a common condition in patients with cirrhosis, and ultrasound, especially CEUS, is an effective and minimally invasive diagnostic tool for evaluating hepatic hemodynamics and lesions. Recent advancements in digital technology have further improved the resolution and expanded the applications of CEUS.
FRONTIERS IN MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Jiahui Li, Tejasav S. Sehrawat, Jingbiao Chen, Moira B. Hilscher, Kevin J. Glaser, Juan P. Arab, Thiago Milech De Assuncao, Douglas A. Simonetto, Taofic Mounajjed, Armando Manduca, Richard L. Ehman, Vijay H. Shah, Meng Yin
Summary: The bi-parametric dual-frequency hepatic MRE model showed improved diagnostic accuracy for predicting portal hypertension in mouse models, especially in cases of hepatic congestion and cholestatic liver injury. This technical advancement has the potential to monitor PHTN progression and treatment efficacy in the presence of varying fibrosis.
EUROPEAN RADIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Fanny Turon, Ellen G. Driever, Anna Baiges, Eira Cerda, Angeles Garcia-Criado, Rosa Gilabert, Concepcio Bru, Annalisa Berzigotti, Isabel Nunez, Lara Orts, Juan Carlos Reverter, Marta Magaz, Genis Camprecios, Pol Olivas, Fabian Betancourt-Sanchez, Valeria Perez-Campuzano, Annabel Blasi, Susana Seijo, Enric Reverter, Jaume Bosch, Roger Borras, Virginia Hernandez-Gea, Ton Lisman, Juan Carlos Garcia-Pagan
Summary: In patients with cirrhosis, the main predictive factors for portal vein thrombosis (PVT) development are related to the severity of portal hypertension. There is no significant relationship between PVT development and other clinical, biochemical, inflammatory, and acquired or hereditary hemostatic parameters.
JOURNAL OF HEPATOLOGY
(2021)