Citation
Merkel, Carlo, et al. "Clinical Significance of Worsening Portal Hypertension During Long-term Medical Treatment in Patients With Cirrhosis Who Had Been Classified as Early Good-responders On Haemodynamic Criteria." Journal of Hepatology, vol. 52, no. 1, 2010, pp. 45-53.
Merkel C, Bolognesi M, Berzigotti A, et al. Clinical significance of worsening portal hypertension during long-term medical treatment in patients with cirrhosis who had been classified as early good-responders on haemodynamic criteria. J Hepatol. 2010;52(1):45-53.
Merkel, C., Bolognesi, M., Berzigotti, A., Amodio, P., Cavasin, L., Casarotto, I. M., Zoli, M., & Gatta, A. (2010). Clinical significance of worsening portal hypertension during long-term medical treatment in patients with cirrhosis who had been classified as early good-responders on haemodynamic criteria. Journal of Hepatology, 52(1), 45-53. https://doi.org/10.1016/j.jhep.2009.10.014
Merkel C, et al. Clinical Significance of Worsening Portal Hypertension During Long-term Medical Treatment in Patients With Cirrhosis Who Had Been Classified as Early Good-responders On Haemodynamic Criteria. J Hepatol. 2010;52(1):45-53. PubMed PMID: 19914730.
TY - JOUR
T1 - Clinical significance of worsening portal hypertension during long-term medical treatment in patients with cirrhosis who had been classified as early good-responders on haemodynamic criteria.
AU - Merkel,Carlo,
AU - Bolognesi,Massimo,
AU - Berzigotti,Annalisa,
AU - Amodio,Piero,
AU - Cavasin,Lucia,
AU - Casarotto,Ilaria Maria,
AU - Zoli,Marco,
AU - Gatta,Angelo,
Y1 - 2009/10/23/
PY - 2009/01/12/received
PY - 2009/07/23/revised
PY - 2009/07/30/accepted
PY - 2009/11/17/entrez
PY - 2009/11/17/pubmed
PY - 2010/9/18/medline
SP - 45
EP - 53
JF - Journal of hepatology
JO - J Hepatol
VL - 52
IS - 1
N2 - BACKGROUND & AIMS: It is established that cirrhotic patients who respond to beta-blockers by lowering their hepatic venous pressure gradient (HVPG) to < or =12 mmHg or by > or =20% of the baseline values are protected from bleeding. However, it is not known whether the effect remains unchanged over the treatment period. METHODS: A group of 24 patients with cirrhosis and oesophageal varices, treated with beta-blockers+/-nitrates, good-responders on haemodynamic criteria, were followed for up to 76 months with sequential HVPG measurements. Another group of 16 patients was used for validation. RESULTS: HVPG worsened in 10 of the 24 patients during follow-up. Changes in HVPG correlated to concomitant changes in liver function parameters. Variceal bleeding occurred in four of the 10 patients whose HVPG had worsened (bleed; 3-21 months after the measured increase in HVPG) and in none of those with stable HVPG (p=0.02). Patients with increased HVPG also had shorter survival (p=0.05). Worsening of HVPG was an independent predictor of death, additive to Child-Pugh or MELD scores, in a time-dependent Cox's regression analysis. This relationship was confirmed in the validation group. CONCLUSIONS: Worsening HVPG during follow-up in patients who had initially been good-responders to medical treatment is related to worsening in hepatic function. The maintenance of a good haemodynamic response to medical treatment of portal hypertension is an excellent predictor of outcome in these patients.
SN - 1600-0641
UR - https://www.unboundmedicine.com/medline/citation/19914730/Clinical_significance_of_worsening_portal_hypertension_during_long_term_medical_treatment_in_patients_with_cirrhosis_who_had_been_classified_as_early_good_responders_on_haemodynamic_criteria_
DB - PRIME
DP - Unbound Medicine
ER -
