Use of non-invasive markers of portal hypertension and timing of screening endoscopy for gastroesophageal varices in patients with chronic liver disease

Hepatology ◽  
2013 ◽  
pp. n/a-n/a
Author(s):  
Annalisa Berzigotti ◽  
Jaime Bosch
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Gastroesophageal Varices ◽  
Non Invasive ◽  
Screening Endoscopy

scholarly journals A study on non endoscopic predictors of esophageal varices and portal hypertension in chronic liver disease

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 228-234
Author(s):  
Karthick M ◽  
Prabakaran P T ◽  
Rajendran K ◽  
Gowrishankar A ◽  
Halleys Kumar E ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Chronic Liver ◽  
First Episode ◽  
Oesophageal Varices ◽  
Screening Endoscopy

Portal hypertension is associated with liver cirrhosis and esophageal varices is a common complication. Cirrhotic liver increases resistance to the passage of blood and thereby increased splanchnic blood flow secondary to vasodilation. Prevalence of portal hypertension varies from 50-60% in patients with liver cirrhosis. The first episode of variceal bleeding causes mortality, which ranges from 40-70%. All cirrhotic patients should be screened for the oesophageal varices according to  Baveno III consensus conference on portal hypertension and recommendation for endoscopy is at 2-3 years intervals in patients without varices and at 1-2 years interval in patients with small varices in order to evaluate the development or variceal progression. But this is questionable as endoscopy is an invasive procedure and also cost-effective. Only 9-36% of patients with cirrhosis were found to have varices on screening endoscopy. Non-invasive assessment of variceal bleeding with good predictivity includes biochemical, clinical and ultrasonographic parameters. Thus unnecessary intervention is avoided and at the same time, the patients at risk of bleeding are also not missed. This study emphasizes the need for an annual ultrasonogram examination as a part of a surveillance program for screening of oesophageal varices in patients of chronic liver disease.

scholarly journals Influence of Genetic Variants on Disease Regression and Outcomes in HCV-Related Advanced Chronic Liver Disease after SVR

2021 ◽  
Vol 11 (4) ◽  
pp. 281
Author(s):  
Georg Semmler ◽  
Teresa Binter ◽  
Karin Kozbial ◽  
Philipp Schwabl ◽  
David Chromy ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Clinical Outcomes ◽  
Genetic Variants ◽  
Antiviral Treatment ◽  
Venous Pressure ◽  
Chronic Liver ◽  
Non Invasive ◽  
Pre Treatment

Genetic variants including PNPLA3-rs738409 C>G, TM6SF2-rs58542926 C>T, MBOAT7-rs641738 C>T, and HSD17B13-rs72613567 T>TA have been shown to influence progression to advanced chronic liver disease (ACLD) in patients with chronic hepatitis C (CHC). We aimed to investigate their impact on disease regression (i.e., changes in hepatic venous pressure gradient [HVPG] and non-invasive surrogates [liver stiffness measurement (LSM), von Willebrand factor (VWF), and VWF/platelet count ratio (VITRO)]) and clinical outcomes after CHC cure in 346 patients with pre-treatment ACLD. Patients carrying the PNPLA3 minor allele had more advanced liver disease prior to antiviral therapy, confirming its impact on liver disease progression. In a subgroup of 88 patients who underwent paired HVPG-measurements and were genotyped for all SNP/indels, PNPLA3/TM6SF2/MBOAT7/HSD17B13 genotypes were not associated with changes in HVPG. In line, changes in non-invasive surrogates of portal hypertension (LSM/VWF/VITRO) were comparable between carriers and non-carriers of the PNPLA3 G-allele in the overall cohort. Finally, carriage of PNPLA3 G-allele was not associated with the development of hepatic decompensation, de-novo hepatocellular carcinoma, or transplant-free mortality during a median follow-up of 42 months after the end of antiviral treatment. Therefore, genetic variants in PNPLA3/TM6SF2/MBOAT7/HSD17B13 do not impact the regression of portal hypertension and clinical outcomes in patients with pre-treatment ACLD after CHC cure.

Are Non Invasive Test Good Enough to Predict Gastroesophageal Varices in Patients with Compensated Advanced Chronic Liver Disease?

2016 ◽  
Vol 64 (2) ◽  
pp. S731-S732 ◽  
Author(s):  
M.L. Gomez ◽  
E.L. Herrera ◽  
J. De la Revilla Negro ◽  
N.F. Puga ◽  
M.T. Marugán ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Gastroesophageal Varices ◽  
Non Invasive ◽  
Invasive Test

scholarly journals Non‐invasive detection of portal hypertension by enhanced liver fibrosis score in patients with different aetiologies of advanced chronic liver disease

2020 ◽  
Vol 40 (7) ◽  
pp. 1713-1724 ◽  
Author(s):  
Benedikt Simbrunner ◽  
Rodrig Marculescu ◽  
Bernhard Scheiner ◽  
Philipp Schwabl ◽  
Theresa Bucsics ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Fibrosis Score ◽  
Non Invasive
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