Document Detail

Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study.
MedLine Citation:
PMID:  21354450     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: The prognosis of patients with chronic liver disease is to a great extent determined by the presence and degree of portal hypertension (PHT). Hepatic venous pressure gradient (HVPG) has been shown to be an accurate prognostic index in patients with cirrhosis. Transient elastography is a non-invasive procedure that assesses liver fibrosis through the measurement of liver stiffness (LS). In several reports, LS was found to be correlated with HVPG. LS could therefore be useful to identify patients with significant PHT. The aim of the present study was to prospectively assess and to compare the prognostic performances of LS and HVPG in patients with chronic liver disease.
METHODS: One hundred patients with chronic liver disease underwent LS and HVPG measurements on the same day. Patients were thereafter followed-up for 2 years or until they experienced a complication related to their liver disease.
RESULTS: Within the two-year follow-up, 41 patients developed, at least, one liver disease related complication. The performances of HVPG and LS for predicting the occurrence of these complications were not significantly different: AUROC 0.815 [0.727-0.903] and 0.837 [0.754-0.920], respectively. When considering only complications related to PHT, both methods were found to be similarly accurate: AUROC 0.830 [0.751-0.910] and 0.845 [0.767-0.823], for HVPG and LS, respectively. When patients were divided in two groups according to a LS value below or above 21.1kPa, actuarial rates of remaining free of any complication at 2 years were 85.4% vs. 29.5%, respectively. When only PHT related complications were considered, these rates were 100% vs. 47.5%, respectively. The performances of LS and HVPG were also similar in the subgroup of 65 patients with cirrhosis.
CONCLUSIONS: LS proved as effective as HVPG in predicting clinical decompensation and PHT related complications in patients with chronic liver disease. Therefore, LS could be a valuable clinical tool to avoid invasive procedures.
Marie Angèle Robic; Bogdan Procopet; Sophie Métivier; Jean Marie Péron; Janick Selves; Jean Pierre Vinel; Christophe Bureau
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-02-25
Journal Detail:
Title:  Journal of hepatology     Volume:  55     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-19     Completed Date:  2012-03-06     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1017-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Service d'Hepato-gastro-entérologie, Pôle Digestif CHU Toulouse, Purpan 31059, Toulouse cedex, France.
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MeSH Terms
Area Under Curve
Chronic Disease
Elasticity / physiology
Elasticity Imaging Techniques*
Esophageal and Gastric Varices / diagnosis,  etiology
Hypertension, Portal / complications*,  diagnosis,  physiopathology*
Kaplan-Meier Estimate
Liver Cirrhosis / complications,  physiopathology
Liver Diseases / complications,  physiopathology*
Middle Aged
Multivariate Analysis
Portal Pressure*
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
ROC Curve
Comment In:
Hepatology. 2012 May;55(5):1629-31   [PMID:  22517548 ]
J Hepatol. 2011 Nov;55(5):955-6   [PMID:  21802463 ]

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