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Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study
This study investigated the feasibility of using erythrocyte (RBC) lifespan determined by Levitt’s CO breath test (LCOBT) to predict esophageal varices needing treatment (VNT) in patients with cirrhosis. BACKGROUND: Esophageal varix bleeding is a common fatal complication of cirrhosis and portal hyp...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402879/ https://www.ncbi.nlm.nih.gov/pubmed/36200958 http://dx.doi.org/10.1097/MCG.0000000000001768 |
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author | Feng, Chu-Wu Kang, Ling-Ling Zhang, Hou-De |
author_facet | Feng, Chu-Wu Kang, Ling-Ling Zhang, Hou-De |
author_sort | Feng, Chu-Wu |
collection | PubMed |
description | This study investigated the feasibility of using erythrocyte (RBC) lifespan determined by Levitt’s CO breath test (LCOBT) to predict esophageal varices needing treatment (VNT) in patients with cirrhosis. BACKGROUND: Esophageal varix bleeding is a common fatal complication of cirrhosis and portal hypertension. The gold standard for identifying VNT is esophagogastroduodenoscopy (EGD), an invasive procedure with low patient compliance. VNT screening based on Baveno VI criteria has mediocre specificity. STUDY: RBC lifespan was determined by LCOBT in 53 cirrhotic patients (13 without varices, 11 mild/moderate varices, and 29 severe varices). Correlation of varix severity with RBC lifespan and other variables was analyzed. Rates of shortened RBC lifespan and thrombocytopenia (Baveno VI criteria) were compared. RESULTS: RBC lifespan correlated inversely with severity of varices (r=−0.793, P<0.001). Mean RBC lifespans were 129±31, 96±21, and 59±21 days for Nonvarix, Mild/Moderate, and Severe groups. Shortened RBC lifespan (<75 d) was observed in 79.3% (23/29) of patients with severe varices, a frequency similar or identical to thrombocytopenia rates [original Baveno VI criteria, 86.2% (25/29), P=0.487; expanded criteria, 79.3% (23/29), P>0.999]. Among 24 patients without severe varices, shortened RBC lifespan was observed in 1 patient whereas thrombocytopenia was detected in 13 and 8 patients based on the original (P<0.001) and expanded criteria (P=0.010), respectively. CONCLUSIONS: RBC lifespan correlates inversely with varix severity in patients with cirrhosis. LCOBT may enable specific screening for VNT. |
format | Online Article Text |
id | pubmed-10402879 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-104028792023-08-05 Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study Feng, Chu-Wu Kang, Ling-Ling Zhang, Hou-De J Clin Gastroenterol Original Articles This study investigated the feasibility of using erythrocyte (RBC) lifespan determined by Levitt’s CO breath test (LCOBT) to predict esophageal varices needing treatment (VNT) in patients with cirrhosis. BACKGROUND: Esophageal varix bleeding is a common fatal complication of cirrhosis and portal hypertension. The gold standard for identifying VNT is esophagogastroduodenoscopy (EGD), an invasive procedure with low patient compliance. VNT screening based on Baveno VI criteria has mediocre specificity. STUDY: RBC lifespan was determined by LCOBT in 53 cirrhotic patients (13 without varices, 11 mild/moderate varices, and 29 severe varices). Correlation of varix severity with RBC lifespan and other variables was analyzed. Rates of shortened RBC lifespan and thrombocytopenia (Baveno VI criteria) were compared. RESULTS: RBC lifespan correlated inversely with severity of varices (r=−0.793, P<0.001). Mean RBC lifespans were 129±31, 96±21, and 59±21 days for Nonvarix, Mild/Moderate, and Severe groups. Shortened RBC lifespan (<75 d) was observed in 79.3% (23/29) of patients with severe varices, a frequency similar or identical to thrombocytopenia rates [original Baveno VI criteria, 86.2% (25/29), P=0.487; expanded criteria, 79.3% (23/29), P>0.999]. Among 24 patients without severe varices, shortened RBC lifespan was observed in 1 patient whereas thrombocytopenia was detected in 13 and 8 patients based on the original (P<0.001) and expanded criteria (P=0.010), respectively. CONCLUSIONS: RBC lifespan correlates inversely with varix severity in patients with cirrhosis. LCOBT may enable specific screening for VNT. Lippincott Williams & Wilkins 2022-09-30 /pmc/articles/PMC10402879/ /pubmed/36200958 http://dx.doi.org/10.1097/MCG.0000000000001768 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Original Articles Feng, Chu-Wu Kang, Ling-Ling Zhang, Hou-De Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title | Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title_full | Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title_fullStr | Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title_full_unstemmed | Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title_short | Prediction of Severe Esophageal Varices in Patients With Cirrhosis Based on Levitt’s CO Breath Test: A Proof of Concept Study |
title_sort | prediction of severe esophageal varices in patients with cirrhosis based on levitt’s co breath test: a proof of concept study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10402879/ https://www.ncbi.nlm.nih.gov/pubmed/36200958 http://dx.doi.org/10.1097/MCG.0000000000001768 |
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