Cargando…

The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data

BACKGROUND/AIMS: Liver stiffness measurement (LSM) has been proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension,...

Descripción completa

Detalles Bibliográficos
Autores principales: Hong, Won Ki, Kim, Moon Young, Baik, Soon Koo, Shin, Seung Yong, Kim, Jung Min, Kang, Yong Seok, Lim, Yoo Li, Kim, Young Ju, Cho, Youn Zoo, Hwang, Hye Won, Lee, Jin Hyung, Chae, Myeong Hun, Kim, Hyoun A, Kang, Hye Won, Kwon, Sang Ok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894436/
https://www.ncbi.nlm.nih.gov/pubmed/24459641
http://dx.doi.org/10.3350/cmh.2013.19.4.370
_version_ 1782299851611963392
author Hong, Won Ki
Kim, Moon Young
Baik, Soon Koo
Shin, Seung Yong
Kim, Jung Min
Kang, Yong Seok
Lim, Yoo Li
Kim, Young Ju
Cho, Youn Zoo
Hwang, Hye Won
Lee, Jin Hyung
Chae, Myeong Hun
Kim, Hyoun A
Kang, Hye Won
Kwon, Sang Ok
author_facet Hong, Won Ki
Kim, Moon Young
Baik, Soon Koo
Shin, Seung Yong
Kim, Jung Min
Kang, Yong Seok
Lim, Yoo Li
Kim, Young Ju
Cho, Youn Zoo
Hwang, Hye Won
Lee, Jin Hyung
Chae, Myeong Hun
Kim, Hyoun A
Kang, Hye Won
Kwon, Sang Ok
author_sort Hong, Won Ki
collection PubMed
description BACKGROUND/AIMS: Liver stiffness measurement (LSM) has been proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. In this study we evaluated the relationship between LSM and HVPG, and the predictive value of LSM for clinically significant portal hypertension (CSPH) and severe portal hypertension in cirrhosis. METHODS: LSM was performed with transient elastography in 59 consecutive cirrhotic patients who underwent hemodynamic HVPG investigations. CSPH and severe portal hypertension were defined as HVPG ≥10 and ≥12 mmHg, respectively. Linear regression analysis was performed to evaluate the relationship between LSM and HVPG. Diagnostic values were analyzed based on receiver operating characteristic (ROC) curves. RESULTS: A strong positive correlation between LSM and HVPG was observed in the overall population (r(2)=0.496, P<0.0001). The area under the ROC curve (AUROC) for the prediction of CSPH (HVPG ≥10 mmHg) was 0.851, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for an LSM cutoff value of 21.95 kPa were 82.5%, 73.7%, 86.8%, and 66.7%, respectively. The AUROC at prediction of severe portal hypertension (HVPG ≥12 mmHg) was 0.877, and the sensitivity, specificity, PPV, and NPV at LSM cutoff value of 24.25 kPa were 82.9%, 70.8%, 80.6%, and 73.9%, respectively. CONCLUSIONS: LSM exhibited a significant correlation with HVPG in patients with cirrhosis. LSM could be a non-invasive method for predicting CSPH and severe portal hypertension in Korean patients with liver cirrhosis.
format Online
Article
Text
id pubmed-3894436
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher The Korean Association for the Study of the Liver
record_format MEDLINE/PubMed
spelling pubmed-38944362014-01-23 The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data Hong, Won Ki Kim, Moon Young Baik, Soon Koo Shin, Seung Yong Kim, Jung Min Kang, Yong Seok Lim, Yoo Li Kim, Young Ju Cho, Youn Zoo Hwang, Hye Won Lee, Jin Hyung Chae, Myeong Hun Kim, Hyoun A Kang, Hye Won Kwon, Sang Ok Clin Mol Hepatol Original Article BACKGROUND/AIMS: Liver stiffness measurement (LSM) has been proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. In this study we evaluated the relationship between LSM and HVPG, and the predictive value of LSM for clinically significant portal hypertension (CSPH) and severe portal hypertension in cirrhosis. METHODS: LSM was performed with transient elastography in 59 consecutive cirrhotic patients who underwent hemodynamic HVPG investigations. CSPH and severe portal hypertension were defined as HVPG ≥10 and ≥12 mmHg, respectively. Linear regression analysis was performed to evaluate the relationship between LSM and HVPG. Diagnostic values were analyzed based on receiver operating characteristic (ROC) curves. RESULTS: A strong positive correlation between LSM and HVPG was observed in the overall population (r(2)=0.496, P<0.0001). The area under the ROC curve (AUROC) for the prediction of CSPH (HVPG ≥10 mmHg) was 0.851, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for an LSM cutoff value of 21.95 kPa were 82.5%, 73.7%, 86.8%, and 66.7%, respectively. The AUROC at prediction of severe portal hypertension (HVPG ≥12 mmHg) was 0.877, and the sensitivity, specificity, PPV, and NPV at LSM cutoff value of 24.25 kPa were 82.9%, 70.8%, 80.6%, and 73.9%, respectively. CONCLUSIONS: LSM exhibited a significant correlation with HVPG in patients with cirrhosis. LSM could be a non-invasive method for predicting CSPH and severe portal hypertension in Korean patients with liver cirrhosis. The Korean Association for the Study of the Liver 2013-12 2013-12-28 /pmc/articles/PMC3894436/ /pubmed/24459641 http://dx.doi.org/10.3350/cmh.2013.19.4.370 Text en Copyright © 2013 by The Korean Association for the Study of the Liver http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hong, Won Ki
Kim, Moon Young
Baik, Soon Koo
Shin, Seung Yong
Kim, Jung Min
Kang, Yong Seok
Lim, Yoo Li
Kim, Young Ju
Cho, Youn Zoo
Hwang, Hye Won
Lee, Jin Hyung
Chae, Myeong Hun
Kim, Hyoun A
Kang, Hye Won
Kwon, Sang Ok
The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title_full The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title_fullStr The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title_full_unstemmed The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title_short The usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: Korean data
title_sort usefulness of non-invasive liver stiffness measurements in predicting clinically significant portal hypertension in cirrhotic patients: korean data
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894436/
https://www.ncbi.nlm.nih.gov/pubmed/24459641
http://dx.doi.org/10.3350/cmh.2013.19.4.370
work_keys_str_mv AT hongwonki theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimmoonyoung theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT baiksoonkoo theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT shinseungyong theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimjungmin theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kangyongseok theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT limyooli theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimyoungju theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT choyounzoo theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT hwanghyewon theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT leejinhyung theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT chaemyeonghun theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimhyouna theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kanghyewon theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kwonsangok theusefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT hongwonki usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimmoonyoung usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT baiksoonkoo usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT shinseungyong usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimjungmin usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kangyongseok usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT limyooli usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimyoungju usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT choyounzoo usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT hwanghyewon usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT leejinhyung usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT chaemyeonghun usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kimhyouna usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kanghyewon usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata
AT kwonsangok usefulnessofnoninvasiveliverstiffnessmeasurementsinpredictingclinicallysignificantportalhypertensionincirrhoticpatientskoreandata