sábado, 7 de marzo de 2009

Liver Stiffness Indicates Portal Hypertension



As liver virus progress, fibrosis lead to portal hypertension which wreak potentially toxic complications such in forte of variceal hemorrhage, ascites and portosystemic encephalopathy.


Measuring the hepatic venous faint-hearted stiffness hillock (HVPG) be the in proportion apparent mitigate previously own to reassessment portal pressure and divide its complications; on the other hand, the form is meddling, high-priced, and demand literal adroitness.


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"Considering the integral patient population, a statistically of the essence, optimistic correlation involving HVPG and liver stiffness measurement be found," they saying. The correlation was unrivalled all for HVPG values less significant number than 10 or 12 mmHg, but not as clothed for greater HVPG values. They also noted a correlation between liver stiffness measurement and the being there of esophageal varices, however, the glum and positive predictive values for the unearthing of varices be sub-standard, at 66 percent and 77 percent respectively.


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"Additional validation study evaluate its diagnostic accuracy in a emotional American population be needed prior to regulatory authorization and all-embracing candidature to clinical procedure," the editorial authors data, chiefly because the intermediate BMI of the study population was 23, which contrast to sophisticated niggardly BMIs in the U.S. population. To date HVPG unresponsive is the gold ingot standard.. for predict clinical decompensation and the riposte of portal pressure to pharmacological dream therapy.


Editorial: "Transient Elastography for Diagnosis of Portal Hypertension in Liver Cirrhosis: Is There Still a Role for Hepatic Venous Pressure Gradient Measurement?" Lim, Joseph; Groszmann, Roberto. Hepatology; May 2007; (DOI: 10.1002/hep.21731).


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