PMID- 37668257
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240106
IS  - 1386-6346 (Print)
IS  - 1386-6346 (Linking)
VI  - 54
IP  - 1
DP  - 2024 Jan
TI  - Prognostic value of virtual portal pressure gradient response in compensated 
      cirrhotic patients treated with carvedilol.
PG  - 78-90
LID - 10.1111/hepr.13963 [doi]
AB  - AIM: This study aimed to assess the prognostic significance of virtual portal 
      pressure gradient (vPPG) response to carvedilol in patients with compensated 
      cirrhosis (CC). METHODS: Compensated cirrhosis patients with high-risk varices 
      were prospectively enrolled to receive carvedilol for prevention of first 
      variceal hemorrhage (VH) and followed up for 1 year. The vPPG response was 
      defined as a reduction of vPPG >10% from baseline after 1-month therapy. Logistic 
      and Cox regression analyses were performed to identify independent predictors for 
      vPPG response and first decompensation, respectively. Competitive risk models 
      were constructed to predict disease progression, and validated using the C-index, 
      Kaplan-Meier analysis, competitive risk analysis, and calibration curves. 
      RESULTS: A total of 129 patients completed this study, of whom 56 (43.4%) 
      achieved vPPG response and were referred as vPPG responders. Baseline vPPG, red 
      color sign, Model for End-stage Liver Disease score, serum monocyte 
      chemoattractant protein-1 (MCP-1), and laminin levels significantly correlated 
      with vPPG response, which itself was further documented as an independent 
      predictor of VH, ascites, and overall decompensation events in CC. Moreover, the 
      red color sign or Child-Turcotte-Pugh score effectively predicted VH, while 
      ascites correlated well with portal flow velocity or MCP-1. The predictive models 
      for VH and ascites showed a good discrimination with C-index values of 0.747 and 
      0.689 respectively, and the high consistency on calibration curves. CONCLUSION: 
      The vPPG response could be used as a noninvasive tool for prediction of disease 
      progression in patients with CC.
CI  - (c) 2023 The Authors. Hepatology Research published by John Wiley & Sons Australia, 
      Ltd on behalf of Japan Society of Hepatology.
FAU - Zhang, Shuo
AU  - Zhang S
AUID- ORCID: 0000-0001-6145-3474
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Cai, Li
AU  - Cai L
AD  - Department of Science and Research, Tongji Hospital, School of Medicine, Tongji 
      University, Shanghai, China.
FAU - Zhong, Hui
AU  - Zhong H
AD  - Department of Infectious Diseases, Fengxian Guhua Hospital, Shanghai, China.
FAU - Yang, Bo
AU  - Yang B
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Song, Weiping
AU  - Song W
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Jia, Haoyu
AU  - Jia H
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Chen, Shuai
AU  - Chen S
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Zhu, Fengshang
AU  - Zhu F
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Li, Jing
AU  - Li J
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
FAU - Yang, Changqing
AU  - Yang C
AD  - Department of Gastroenterology and Hepatology, Tongji Hospital, School of 
      Medicine, Tongji University, Shanghai, China.
LA  - eng
GR  - SHDC2020CR2030B/Clinical research plan of SHDC/
GR  - 21ZR1481600/Shanghai Municipal Science and Technology Commission Original 
      Exploration Project/
GR  - 818201008006/National Natural Science Foundation of China/
GR  - SHSLCZDZK06801/Shanghai Municipal Key Specialty Project/
GR  - 17411970600/Western Medicine Guidance Project/
GR  - 2021E02075/Science and Technology Aid Xinjiang program/
PT  - Journal Article
DEP - 20230920
PL  - Netherlands
TA  - Hepatol Res
JT  - Hepatology research : the official journal of the Japan Society of Hepatology
JID - 9711801
OTO - NOTNLM
OT  - carvedilol
OT  - compensated cirrhosis
OT  - first variceal hemorrhage
OT  - noninvasive
OT  - virtual portal pressure gradient response
EDAT- 2023/09/05 12:42
MHDA- 2023/09/05 12:43
CRDT- 2023/09/05 07:52
PHST- 2023/08/06 00:00 [revised]
PHST- 2023/06/10 00:00 [received]
PHST- 2023/08/30 00:00 [accepted]
PHST- 2023/09/05 12:43 [medline]
PHST- 2023/09/05 12:42 [pubmed]
PHST- 2023/09/05 07:52 [entrez]
AID - 10.1111/hepr.13963 [doi]
PST - ppublish
SO  - Hepatol Res. 2024 Jan;54(1):78-90. doi: 10.1111/hepr.13963. Epub 2023 Sep 20.