Noninvasive Evaluation of Portal Hypertension: Emerging Tools and Techniques

Overview

Journal Int J Hepatol

Publisher Wiley

Specialty Gastroenterology

Date 2012 Jun 22

PMID 22720166

Citations 11

Authors

V K Snowdon

N Guha

J A Fallowfield

Affiliations

Soon will be listed here.

Abstract

Portal hypertension is the main cause of complications in patients with cirrhosis. However, evaluating the development and progression of portal hypertension represents a challenge for clinicians. There has been considerable focus on the potential role of noninvasive markers of portal hypertension that could be used to stratify patients with respect to the stage of portal hypertension and to monitor disease progression or treatment response in a longitudinal manner without having to undertake repeated invasive assessment. The pathogenesis of portal hypertension is increasingly understood and emerging knowledge of the vascular processes that underpin portal hypertension has paved the way for exploring novel biomarkers of vascular injury, angiogenesis, and endothelial dysfunction. In this paper we focus on the pathogenesis of portal hypertension and potential non-invasive biomarkers with particular emphasis on serum analytes.

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References

Sebastiani G, Tempesta D, Fattovich G, Castera L, Halfon P, Bourliere M . Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study. J Hepatol. 2010; 53(4):630-8. DOI: 10.1016/j.jhep.2010.04.019. View

Hartleb M, Kirstetter P, Moreau R, Soupison T, Pussard E, Hadengue A . [Relationships between plasma concentrations of endothelin and the severity of liver cirrhosis]. Gastroenterol Clin Biol. 1994; 18(5):407-12. View

Huang H, Haq O, Utsumi T, Sethasine S, Abraldes J, Groszmann R . Intestinal and plasma VEGF levels in cirrhosis: the role of portal pressure. J Cell Mol Med. 2011; 16(5):1125-33. PMC: 3213314. DOI: 10.1111/j.1582-4934.2011.01399.x. View

Geerts A, De Vriese A, Vanheule E, Van Vlierberghe H, Mortier S, Cheung K . Increased angiogenesis and permeability in the mesenteric microvasculature of rats with cirrhosis and portal hypertension: an in vivo study. Liver Int. 2006; 26(7):889-98. DOI: 10.1111/j.1478-3231.2006.01308.x. View

De Franchis R . Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2010; 53(4):762-8. DOI: 10.1016/j.jhep.2010.06.004. View

Schepis F, Camma C, Niceforo D, Magnano A, Pallio S, Cinquegrani M . Which patients with cirrhosis should undergo endoscopic screening for esophageal varices detection?. Hepatology. 2001; 33(2):333-8. DOI: 10.1053/jhep.2001.21410. View

Vizzutti F, Romanelli R, Arena U, Rega L, Brogi M, Calabresi C . ADMA correlates with portal pressure in patients with compensated cirrhosis. Eur J Clin Invest. 2007; 37(6):509-15. DOI: 10.1111/j.1365-2362.2007.01814.x. View

Hasegawa T, Kimura T, Sasaki T, Okada A . Plasma endothelin-1 level as a marker reflecting the severity of portal hypertension in biliary atresia. J Pediatr Surg. 2001; 36(11):1609-12. DOI: 10.1053/jpsu.2001.27929. View

Thabut D, Moreau R, Lebrec D . Noninvasive assessment of portal hypertension in patients with cirrhosis. Hepatology. 2011; 53(2):683-94. DOI: 10.1002/hep.24129. View

10.

Robic M, Procopet B, Metivier S, Peron J, Selves J, Vinel J . Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study. J Hepatol. 2011; 55(5):1017-24. DOI: 10.1016/j.jhep.2011.01.051. View

11.

Thalheimer U, Bellis L, Puoti C, Burroughs A . Should we routinely measure portal pressure in patients with cirrhosis, using hepatic venous pressure gradient (HVPG) as a guide for prophylaxis and therapy of bleeding and rebleeding? No. Eur J Intern Med. 2011; 22(1):5-7. DOI: 10.1016/j.ejim.2010.12.006. View

12.

Rockey D, Chung J . Reduced nitric oxide production by endothelial cells in cirrhotic rat liver: endothelial dysfunction in portal hypertension. Gastroenterology. 1998; 114(2):344-51. DOI: 10.1016/s0016-5085(98)70487-1. View

13.

Talwalkar J, Yin M, Venkatesh S, Rossman P, Grimm R, Manduca A . Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol. 2009; 193(1):122-7. PMC: 2860633. DOI: 10.2214/AJR.07.3504. View

14.

de Franchis R . Stellate cells and the "reversible component" of portal hypertension. Dig Liver Dis. 2000; 32(2):104-7. DOI: 10.1016/s1590-8658(00)80394-1. View

15.

Gressner A, Tittor W, Negwer A . Serum concentrations of laminin and aminoterminal propeptide of type III procollagen in relation to the portal venous pressure of fibrotic liver diseases. Clin Chim Acta. 1986; 161(3):249-58. DOI: 10.1016/0009-8981(86)90008-2. View

16.

Bosch J, Garcia-Pagan J . Complications of cirrhosis. I. Portal hypertension. J Hepatol. 2000; 32(1 Suppl):141-56. DOI: 10.1016/s0168-8278(00)80422-5. View

17.

Spahr L, Giostra E, Frossard J, Morard I, Mentha G, Hadengue A . A 3-month course of long-acting repeatable octreotide (sandostatin LAR) improves portal hypertension in patients with cirrhosis: a randomized controlled study. Am J Gastroenterol. 2007; 102(7):1397-405. DOI: 10.1111/j.1572-0241.2007.01262.x. View

18.

Chavalitdhamrong D, Jensen D, Singh B, Kovacs T, Han S, Durazo F . Capsule endoscopy is not as accurate as esophagogastroduodenoscopy in screening cirrhotic patients for varices. Clin Gastroenterol Hepatol. 2011; 10(3):254-8.e1. DOI: 10.1016/j.cgh.2011.11.027. View

19.

Laleman W, Omasta A, van de Casteele M, Zeegers M, Vander Elst I, Van Landeghem L . A role for asymmetric dimethylarginine in the pathophysiology of portal hypertension in rats with biliary cirrhosis. Hepatology. 2005; 42(6):1382-90. DOI: 10.1002/hep.20968. View

20.

Lluch P, Torondel B, Medina P, Segarra G, del Olmo J, Serra M . Plasma concentrations of nitric oxide and asymmetric dimethylarginine in human alcoholic cirrhosis. J Hepatol. 2004; 41(1):55-9. DOI: 10.1016/j.jhep.2004.03.016. View