Detection of early portal hypertension with routine data and liver stiffness in patients with asymptomatic liver disease: A prospective study

• Published in: Journal of hepatology 2014-03, Vol.60 (3), p.561-569
• Main Authors: Augustin, Salvador, Millán, Laura, González, Antonio, Martell, María, Gelabert, Arántzazu, Segarra, Antoni, Serres, Xavier, Esteban, Rafael, Genescà, Joan
• Format: Article
• Language: English
• Subjects: Abdomen - diagnostic imaging; Adult; Aged; Aged, 80 and over; Compensated cirrhosis; Elasticity Imaging Techniques; Endoscopy; Esophageal varices; Female; Gastroenterology and Hepatology; Humans; HVPG; Hypertension, Portal - complications; Hypertension, Portal - diagnosis; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver disease; Male; Middle Aged; Non-invasive diagnosis; Platelet Count; Prospective Studies; Transient elastography
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2013.10.027

Background & Aims Detecting portal hypertension (PH) before the development of varices is important for prognosis and for designing interventional studies. None of the available strategies is used in practice. We evaluated a sequential screening-diagnostic strategy based on clinical data and transient elastography (TE) to detect PH in asymptomatic outpatients with liver disease. Methods Consecutive patients with chronic liver disease and no previous diagnosis of PH were screened by TE. Patients with liver stiffness (LS) ⩾13.6 kPa were further evaluated by endoscopy and hepatic venous pressure gradient (HVPG). For analysis, patients were classified in 3 groups: group A, platelets ⩾150,000/mm3 , normal abdominal ultrasound; group B, platelets