Non-selective β-blockers improve the correlation of liver stiffness and portal pressure in advanced cirrhosis

Background Liver stiffness (LS) correlates with portal pressure (hepatic venous pressure gradient, HVPG). However, the dynamic components of portal hypertension (PHT) in advanced cirrhosis may not be adequately assessed by TE. The influence of treatment with non-selective β-blockers (NSBB) on the co...

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Bibliographic Details
Published in:Journal of gastroenterology 2012-05, Vol.47 (5), p.561-568
Main Authors: Reiberger, T., Ferlitsch, A., Payer, B. A., Pinter, M., Homoncik, M., Peck-Radosavljevic, M.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adrenergic beta-Antagonists - pharmacology
Adrenergic beta-Antagonists - therapeutic use
Adult
Biliary Tract
Carbazoles - pharmacology
Carbazoles - therapeutic use
Colorectal Surgery
Elasticity - drug effects
Elasticity Imaging Techniques - methods
Esophageal and Gastric Varices - complications
Esophageal and Gastric Varices - physiopathology
Feasibility Studies
Female
Gastroenterology
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Hemorrhage - physiopathology
Gastrointestinal Hemorrhage - prevention & control
Hemodynamics - drug effects
Hemodynamics - physiology
Hepatology
Humans
Hypertension, Portal - diagnostic imaging
Hypertension, Portal - etiology
Hypertension, Portal - physiopathology
Liver - physiopathology
Liver Cirrhosis - complications
Liver Cirrhosis - diagnostic imaging
Liver Cirrhosis - drug therapy
Liver Cirrhosis - physiopathology
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article—Liver
Pancreas
Portal Pressure - drug effects
Portal Pressure - physiology
Propanolamines - pharmacology
Propanolamines - therapeutic use
Propranolol - pharmacology
Propranolol - therapeutic use
Prospective Studies
Surgical Oncology
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Summary:Background Liver stiffness (LS) correlates with portal pressure (hepatic venous pressure gradient, HVPG). However, the dynamic components of portal hypertension (PHT) in advanced cirrhosis may not be adequately assessed by TE. The influence of treatment with non-selective β-blockers (NSBB) on the correlation of HVPG and LS has not been investigated. Methods One hundred and twenty-two patients with esophageal varices were included. LS, hemodynamic parameters, and HVPG were recorded at baseline (BL) and after 6 weeks of treatment with NSBB (FU). The correlation of LS and HVPG was compared to control patients with HVPG ≤ 12 mmHg. Results Patients with higher Child-Pugh stages (A:88/B:25/C:9) had higher levels of liver stiffness (47.4 ± 16.5 vs. 70.3 ± 7.9 vs. 73.7 ± 2.1 kPa) and HVPG (21 ± 5 vs. 26 ± 5 vs. 26 ± 4 mmHg). The correlation of LS and HVPG was stronger in controls with HVPG ≤ 12 mmHg ( R  = 0.951; P   12 mmHg ( R  = 0.538; P  = 0.0004). The association of HVPG with LS became stronger under treatment with NSBB, which finally restored the linear correlation of HVPG and LS ( R  = 0.930; P   12 mmHg. Measurement of LS by TE is not a feasible method to assess the dynamic components of PHT.
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-011-0517-4