Academic Journal
Hepatic venous pressure gradient predicts risk of hepatic decompensation and liver-related mortality in patients with MASLD
| العنوان: | Hepatic venous pressure gradient predicts risk of hepatic decompensation and liver-related mortality in patients with MASLD |
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| المؤلفون: | Paternostro R., Kwanten W. J., Hofer B. S., Semmler G., Bagdadi A., Luzko I., Hernandez-Gea V., Graupera I., Garcia-Pagan J. C., Saltini D., Indulti F., Schepis F., Moga L., Rautou P. -E., Llop E., Tellez L., Albillos A., Fortea J. I., Puente A., Tosetti G., Primignani M., Zipprich A., Vuille-Lessard E., Berzigotti A., Taru M. -G., Taru V., Procopet B., Jansen C., Praktiknjo M., Gu W., Trebicka J., Ibanez-Samaniego L., Banares R., Rivera-Esteban J., Pericas J. M., Genesca J., Alvarado E., Villanueva C., Larrue H., Bureau C., Laleman W., Ardevol A., Masnou H., Vanwolleghem T., Trauner M., Mandorfer M., Francque S., Reiberger T. |
| المساهمون: | Paternostro, R., Kwanten, W. J., Hofer, B. S., Semmler, G., Bagdadi, A., Luzko, I., Hernandez-Gea, V., Graupera, I., Garcia-Pagan, J. C., Saltini, D., Indulti, F., Schepis, F., Moga, L., Rautou, P. -E., Llop, E., Tellez, L., Albillos, A., Fortea, J. I., Puente, A., Tosetti, G., Primignani, M., Zipprich, A., Vuille-Lessard, E., Berzigotti, A., Taru, M. -G., Taru, V., Procopet, B., Jansen, C., Praktiknjo, M., Gu, W., Trebicka, J., Ibanez-Samaniego, L., Banares, R., Rivera-Esteban, J., Pericas, J. M., Genesca, J., Alvarado, E., Villanueva, C., Larrue, H., Bureau, C., Laleman, W., Ardevol, A., Masnou, H., Vanwolleghem, T., Trauner, M., Mandorfer, M., Francque, S., Reiberger, T. |
| سنة النشر: | 2024 |
| المجموعة: | Archivio della ricerca dell'Università di Modena e Reggio Emilia (Unimore: IRIS) |
| مصطلحات موضوعية: | advanced chronic liver disease, hepatic decompensation, hepatic venous pressure gradient, MASLD, portal hypertension |
| الوصف: | Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of advanced chronic liver disease (ACLD). Portal hypertension drives hepatic decompensation and is best diagnosed by hepatic venous pressure gradient (HVPG) measurement. Here, we investigate the prognostic value of HVPG in MASLD-related compensated ACLD (MASLD-cACLD). Methods: This European multicentre study included patients with MASLD-cACLD characterised by HVPG at baseline. Hepatic decompensation (variceal bleeding/ascites/hepatic encephalopathy) and liver-related mortality were considered the primary events of interest. Results: A total of 340 patients with MASLD-cACLD (56.2% male; median age 62 [55-68] years, median MELD 8 [7-9], 71.2% with diabetes) were included. Clinically significant portal hypertension (CSPH: i.e., HVPG ≥10 mmHg) was found in 209 patients (61.5%). During a median follow-up of 41.5 (27.5-65.8) months, 65 patients developed hepatic decompensation with a cumulative incidence of 10.0% after 2 years (2Y) and 30.7% after 5 years (5Y) in those with MASLD-cACLD with CSPH, compared to 2.4% after 2Y and 9.4% after 5Y in patients without CSPH. Variceal bleeding did not occur without CSPH. CSPH (subdistribution hazard ratio [SHR] 5.13; p <0.001) was associated with an increased decompensation risk and a higher HVPG remained an independent risk factor in the multivariable model (adjusted SHR per mmHg: 1.12, p <0.001). Liver-related mortality occurred in 37 patients at a cumulative incidence of 3.3% after 2Y and 21.4% after 5Y in CSPH. Without CSPH, the incidence after 5Y was 0.8%. Accordingly, a higher HVPG was also independently associated with a higher risk of liver-related death (adjusted SHR per mmHg: 1.20, p <0.001). Conclusion: HVPG measurement is of high prognostic value in MASLD-cACLD. In patients with MASLD-cACLD without CSPH, the short-term risk of decompensation is very low and liver-related mortality is rare, while the presence of CSPH substantially increases the risk of ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38823501; info:eu-repo/semantics/altIdentifier/wos/WOS:001343359800001; volume:81; issue:5; firstpage:827; lastpage:836; journal:JOURNAL OF HEPATOLOGY; https://hdl.handle.net/11380/1365514 |
| DOI: | 10.1016/j.jhep.2024.05.033 |
| الاتاحة: | https://hdl.handle.net/11380/1365514 https://doi.org/10.1016/j.jhep.2024.05.033 |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B788A397 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jhep.2024.05.033 |
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