دورية أكاديمية
أعرض في EDS

Spleen Transient Elastography and Damping Index Identify a Subgroup of Patients Without an Acute or Chronic Response to Beta-Blockers.

التفاصيل البيبلوغرافية
العنوان: Spleen Transient Elastography and Damping Index Identify a Subgroup of Patients Without an Acute or Chronic Response to Beta-Blockers.
المؤلفون: Llop E; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Perelló C; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Fontanilla T; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., de la Revilla J; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Conde MH; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., López M; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Minaya J; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Ferre C; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Abad J; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Carrillo CF; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Martínez JL; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Puga NF; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Trapero M; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain., Hajra IE; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Santos E; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain., Calleja JL; Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; Instituto de Investigación Sanitaria Puerta Hierro-Segovia Arana (IDIPHISA), Madrid, Spain.; CIBERHD, Madrid, Spain.
المصدر: Frontiers in medicine [Front Med (Lausanne)] 2022 Jun 22; Vol. 9, pp. 900073. Date of Electronic Publication: 2022 Jun 22 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101648047 Publication Model: eCollection Cited Medium: Print ISSN: 2296-858X (Print) Linking ISSN: 2296858X NLM ISO Abbreviation: Front Med (Lausanne) Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Lausanne, Switzerland : Frontiers Media S.A., [2014]-
مستخلص: Background and Aims: Monitoring of acute or chronic response to beta-blockers in patients with liver cirrhosis is based on the measurement of the HVPG. Our aim was to evaluate the response to beta-blockers with non-invasive techniques.
Patients and Methods: This is a prospective observational study. Consecutive patients with an indication of primary or secondary prophylaxis of variceal bleeding who did not meet exclusion criteria were included. Acute response and chronic response were evaluated. Baseline and after acute and chronic response hepatosplenic measurements of TE and ARFI were obtained. Contrast-enhanced Doppler ultrasound was performed before and after acute and chronic responses.
Results: From June 2015 to May 2018, 55 patients (14 with exclusion criteria) were included. We analyzed 41 patients, mean age 57 ( SD : 8), 82.9% men, alcohol 43.9%, children A/B/C 78%/17.1%/4.9%, and 87.8% on primary prophylaxis. In all, the acute response was performed and was positive in 68.3% (CI 95: 55-85%). The chronic response was performed in 30 (73.2%) and was positive in 36.7% (CI 95: 18-55%). Basal measurements significantly related to acute response were spleen TE [responders 58.4 ( SD : 23.0) KPa vs. non-responders 75 ( SD : 0) KPa; p = 0.02] and damping index [non-responders 0.96 (0.8) vs. responders 0.44 (0.4), p = 0.01], and with chronic response, the spleen TE [responders 58.1 ( SD : 21.4) KPa vs. non-responders 73.2 ( SD : 5.5) KPa; p = 0.02], and damping index [non-chronic responders 0.8 (0.7) vs. chronic responders 0.4 (0.4), p = 0.04]. A spleen TE ≥ 74 KPa had a high sensitivity of 100% and specificity of 60% and a high NPV100% for predicting poor acute response to beta-blockers. The damping index > 0.6 showed moderate sensitivity of 67% and specificity of 69% with a high NPV of 82% for predicting poor acute response to beta-blockers. The combination of both measurements for predicting poor acute response to beta-blockers had an AUC of 0.8 (CI 95: 0.5-0.9). A spleen TE ≥ 74 KPa had a high sensitivity of 87% and specificity of 71% with a high NPV of 71% for predicting poor chronic response to beta-blockers. A damping index > 0.6 had moderate sensitivity of 60%, specificity of 82%, and NPV of 56% for predicting poor chronic response to beta-blockers. The combination of both measurements for predicting poor chronic response to beta-blockers had an AUC of 0.8 (CI 95: 0.7-0.9).
Conclusion: Spleen TE and damping index can identify a subgroup of patients with poor acute or chronic response to beta-blockers.
Competing Interests: JC reports consultancy and lecture fees from Abbvie, Gilead Sciences, MSD. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Llop, Perelló, Fontanilla, de la Revilla, Conde, López, Minaya, Ferre, Abad, Carrillo, Martínez, Puga, Trapero, Hajra, Santos and Calleja.)
References: Clin Res Hepatol Gastroenterol. 2018 Jun;42(3):216-226. (PMID: 29223365)
Hepatology. 2007 May;45(5):1290-7. (PMID: 17464971)
Liver Int. 2013 Jan;33(1):62-71. (PMID: 22973991)
Radiology. 2016 May;279(2):609-19. (PMID: 26588019)
Ultraschall Med. 2011 Dec;32(6):548-68; quiz 569-71. (PMID: 22161554)
Hepatol Int. 2020 Sep;14(5):850-857. (PMID: 32557193)
Liver Int. 2007 Oct;27(8):1103-10. (PMID: 17845539)
Ultrasound Med Biol. 2017 Jan;43(1):59-68. (PMID: 27751595)
J Magn Reson Imaging. 2018 Oct;48(4):1091-1103. (PMID: 29638020)
J Gastroenterol Hepatol. 2011 Jan;26(1):164-70. (PMID: 21175810)
J Hepatol. 2004 May;40(5):757-65. (PMID: 15094222)
Gut. 2017 Mar;66(3):558-559. (PMID: 27196577)
Expert Rev Gastroenterol Hepatol. 2018 Jan;12(1):91-98. (PMID: 29186994)
Eur Radiol. 2014 Jun;24(6):1394-402. (PMID: 24626745)
Eur Radiol. 2018 Dec;28(12):5221-5230. (PMID: 29858640)
N Engl J Med. 1996 Jun 20;334(25):1624-9. (PMID: 8628357)
Lancet. 2003 Mar 15;361(9361):952-4. (PMID: 12648985)
Hepatol Int. 2018 Feb;12(Suppl 1):81-90. (PMID: 28634688)
Gastroenterology. 2009 Jul;137(1):119-28. (PMID: 19344721)
J Hepatol. 2008 Feb;48(2):229-36. (PMID: 18093686)
Am J Gastroenterol. 2006 Mar;101(3):506-12. (PMID: 16542287)
J Viral Hepat. 2013 Dec;20(12):867-74. (PMID: 24304456)
Am J Gastroenterol. 2007 May;102(5):1116-26. (PMID: 17391317)
Med Ultrason. 2011 Jun;13(2):135-40. (PMID: 21655540)
N Engl J Med. 2005 Nov 24;353(21):2254-61. (PMID: 16306522)
Gastroenterology. 2012 Sep;143(3):646-654. (PMID: 22643348)
Ultraschall Med. 2012 Feb;33(1):8-32; quiz 30-1. (PMID: 22322479)
Aliment Pharmacol Ther. 2008 Jun;27(12):1261-8. (PMID: 18397389)
J Hepatol. 2009 Aug;51(2):279-87. (PMID: 19501930)
Eur J Gastroenterol Hepatol. 2015 Sep;27(9):992-1001. (PMID: 26020376)
J Ultrasound. 2016 Dec 01;20(1):43-52. (PMID: 28298943)
J Hepatol. 2019 Mar;70(3):412-422. (PMID: 30389550)
J Hepatol. 2017 Aug;67(2):399-411. (PMID: 28223101)
J Hepatol. 2015 Sep;63(3):743-52. (PMID: 26047908)
Radiology. 2014 Dec;273(3):917-26. (PMID: 25025464)
Ultraschall Med. 2015 Dec;36(6):603-10. (PMID: 26565516)
فهرسة مساهمة: Keywords: acute response to betablockers; chronic response to betablockers; damping index; spleen stiffness; transient elastography
تواريخ الأحداث: Date Created: 20220711 Latest Revision: 20220716
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC9258685
DOI: 10.3389/fmed.2022.900073
PMID: 35814751
قاعدة البيانات: MEDLINE
الوصف
تدمد:2296-858X
DOI:10.3389/fmed.2022.900073