Non-invasive tools for compensated advanced chronic liver disease and portal hypertension after Baveno VII – an update

Segna, Daniel; Mendoza, Yuly; Lange, Naomi; Rodrigues, Susana; Berzigotti, Annalisa

doi:10.1016/j.dld.2022.10.009

Cited by 11 publications

(2 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Beyond diagnostics, elastography exhibits considerable potential in monitoring the response to liver disease treatment. Regular monitoring of the degree of liver fibrosis is crucial for evaluating the therapeutic effect and adjusting treatment plans, especially for patients with chronic liver disease undergoing antiviral or anti-fibrosis treatment [18,19]. Elastic imaging technology, with its non-invasive nature, provides an ideal tool for tracking changes in liver hardness.…”

Section: Role and Advantages Of Elastic Imaging In Quantitative Evalu...mentioning

confidence: 99%

Progress and Prospects of Elastography Techniques in the evaluation of fibrosis in chronic liver disease

Wang,

Yang,

Wang

2024

Arch Med Sci

View full text Add to dashboard Cite

The precise assessment of liver fibrosis degree is imperative for monitoring and managing chronic liver diseases. Traditionally, liver biopsy and quantitative blood biomarkers have been the mainstays for fibrosis assessment, albeit each with its inherent limitations. However, the emergence of elastography presents a promising non-invasive alternative, potentially supplanting or complementing traditional biomarkers. In contrast to conventional biomarkers, elastography offers several advantages. Firstly, it is non-invasive, sidestepping the risks and discomfort associated with liver biopsy. Secondly, this technique provides real-time and intuitive fibrosis assessments, characterized by user-friendly operation and high reproducibility. Thirdly, elastography excels in diagnosing moderate to severe fibrosis, vital for determining treatment strategies and monitoring disease progression. Notably, MRE stands out as the most accurate non-invasive method for fibrosis assessment, especially suitable for advanced fibrotic stages. This article provides an overview of the advancements in elastography as a viable quantitative biomarker for chronic liver disease fibrosis burden.

show abstract

Section: Role and Advantages Of Elastic Imaging In Quantitative Evalu...mentioning

confidence: 99%

Progress and Prospects of Elastography Techniques in the evaluation of fibrosis in chronic liver disease

Wang,

Yang,

Wang

2024

Arch Med Sci

View full text Add to dashboard Cite

show abstract

“…In the last decade, the progressive development of tools non-invasively assessing the degree of hepatic fibrosis in patients with chronic liver diseases (CLDs) has allowed the identification of cirrhosis at the earlier and asymptomatic stage of compensated advanced CLD (cACLD), revolutionizing the clinical management and conditioning the therapeutic interventions potentially impacting on prognosis[ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

Dallio,

Romeo,

Vaia

et al. 2024

World J Gastroenterol

View full text Add to dashboard Cite

BACKGROUND For compensated advanced chronic liver disease (cACLD) patients, the first decompensation represents a dramatically worsening prognostic event. Based on the first decompensation event (DE), the transition to decompensated advanced chronic liver disease (dACLD) can occur through two modalities referred to as acute decompensation (AD) and non-AD (NAD), respectively. Clinically Significant Portal Hypertension (CSPH) is considered the strongest predictor of decompensation in these patients. However, due to its invasiveness and costs, CSPH is almost never evaluated in clinical practice. Therefore, recognizing non-invasively predicting tools still have more appeal across healthcare systems. The red cell distribution width to platelet ratio (RPR) has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). However, its predictive role for the decompensation has never been explored. AIM In this observational study, we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients. METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up (FUP) semiannually for 3 years. At baseline, biochemical, clinical, and Liver Stiffness Measurement (LSM), Child-Pugh (CP), Model for End-Stage Liver Disease (MELD), aspartate aminotransferase/platelet count ratio index (APRI), Fibrosis-4 (FIB-4), Albumin-Bilirubin (ALBI), ALBI-FIB-4, and RPR were collected. During FUP, DEs (timing and modalities) were recorded. CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines. RESULTS Of 150 MASLD-related cACLD patients, 43 (28.6%) progressed to dACLD at a median time of 28.9 months (29 NAD and 14 AD). Baseline RPR values were significantly higher in cACLD in comparison to controls, as well as MELD, CP, APRI, FIB-4, ALBI, ALBI-FIB-4, and LSM in dACLD-progressing compared to cACLD individuals [all P < 0.0001, except for FIB-4 (P : 0.007) and ALBI (P : 0.011)]. Receiving operator curve analysis revealed RPR > 0.472 and > 0.894 as the best cut-offs in the prediction respectively of 3-year first DE, as well as its superiority compared to the other non-invasive tools examined. RPR (P : 0.02) and the presence of baseline-CSPH (P : 0.04) were significantly and independently associated with the DE. Patients presenting baseline-CSPH and RPR > 0.472 showed higher risk of decompensation (P : 0.0023). CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.

show abstract

Evolving portal hypertension through Baveno VII recommendations

Mendizabal,

Cançado,

Albillos

2024

Annals of Hepatology

View full text Add to dashboard Cite

Non-invasive tools for compensated advanced chronic liver disease and portal hypertension after Baveno VII – an update

Cited by 11 publications

References 90 publications

Progress and Prospects of Elastography Techniques in the evaluation of fibrosis in chronic liver disease

Progress and Prospects of Elastography Techniques in the evaluation of fibrosis in chronic liver disease

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

Evolving portal hypertension through Baveno VII recommendations

Contact Info

Product

Resources

About