ArticleDigestive diseases and sciences2023
Assessment of the Performance of Non-invasive Criteria for the Evaluation of Clinically Significant Portal Hypertension in Patients with Compensated Advanced Chronic Liver Disease.
Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 9 citations in OpenAlex.
- CT-Derived spleen volume accurately diagnoses severe portal hypertension at HVPG thresholds of 16 mmhg.Scientific reports · 2025Article
- Non-invasive assessment of portal hypertension: Liver stiffness and beyond.JHEP reports : innovation in hepatology · 2025Review
- Use of Noninvasive Tests to Assess Clinically Significant Portal Hypertension and Response to Beta-Blockers.Gastro hep advances · 2025Review
- Utility of different Baveno criteria to detect esophageal varices irrespective of their size in patients with compensated cirrhosis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Article
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6 authors at 2 institutions in 1 country.
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Abstract
BACKGROUND AND
aimsAssessment of clinically significant portal hypertension (CSPH) non-invasively using a combination of liver stiffness measurement (LSM) and platelet counts is proposed as an alternative to hepatic venous pressure gradient (HVPG) estimation. Utility of these criteria in compensated advanced chronic liver disease (cACLD) patients of different etiologies including nonalcoholic steatohepatitis (NASH) with BMI > 30 kg/m
methodsConsecutive patients of cACLD with available anthropometric and laboratory details, LSM, and HVPG were included in a retrospective analysis. A LSM of ≥ 25 kPa alone and LSM ≤ 15 kPa plus platelets ≥ 150 × 10
resultsPatients with cACLD (n = 626) (mean age: 50.8 ± 12.4 years, 74.2% males) with alcohol (ALD, 30.3%), NASH (26.4%), hepatitis C (HCV, 16.6%), hepatitis B (HBV,10.2%) etiology were included. The prevalence of CSPH was > 80% across all etiologies except in HBV (62.5%) and in obese non-NASH (71-72%). The rule-in criteria had a PPV > 90% for all etiologies except in HBV (80.8%). The rule-out criteria had a negative predictive value (NPV) of 65%, 53%, and 40% in ALD, HCV, and NASH, respectively. The NASH-ANTCIPATE model had specificity of 100% and NPV of 33% to detect CSPH in obese NASH (n = 62).
conclusionsLSM ≥ 25 kPa predicted CSPH in most etiologies except HBV. A significant proportion of patients have CSPH despite satisfying the rule-out criteria. The NASH-ANTICIPATE model is specific but fails to exclude CSPH in nearly two-third patients with obesity and NASH. There is a need for precise disease-specific non-invasive models for detecting CSPH.
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