Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension

BACKGROUND AND AIMS: Liver stiffness is increasingly used in the non-invasive evaluation of chronic liver diseases. Liver stiffness correlates with hepatic venous pressure gradient (HVPG) in patients with cirrhosis and holds prognostic value in this population. Hence, accuracy in its measurement is...

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Autores: Berzigotti, Annalisa, Gottardi, Andrea de, Vukotic, Ranka, Siramolpiwat, Sith, Abraldes, Juan G., García Pagán, Juan Carlos, Bosch i Genover, Jaume
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/54883
Acesso em linha:https://hdl.handle.net/2445/54883
Access Level:acceso abierto
Palavra-chave:Cirrosi hepàtica
Hipertensió portal
Assaigs clínics
Hepatic cirrhosis
Portal hypertension
Clinical trials
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spelling Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertensionBerzigotti, AnnalisaGottardi, Andrea deVukotic, RankaSiramolpiwat, SithAbraldes, Juan G.García Pagán, Juan CarlosBosch i Genover, JaumeCirrosi hepàticaHipertensió portalAssaigs clínicsHepatic cirrhosisPortal hypertensionClinical trialsBACKGROUND AND AIMS: Liver stiffness is increasingly used in the non-invasive evaluation of chronic liver diseases. Liver stiffness correlates with hepatic venous pressure gradient (HVPG) in patients with cirrhosis and holds prognostic value in this population. Hence, accuracy in its measurement is needed. Several factors independent of fibrosis influence liver stiffness, but there is insufficient information on whether meal ingestion modifies liver stiffness in cirrhosis. We investigated the changes in liver stiffness occurring after the ingestion of a liquid standard test meal in this population. METHODS: In 19 patients with cirrhosis and esophageal varices (9 alcoholic, 9 HCV-related, 1 NASH; Child score 6.9±1.8), liver stiffness (transient elastography), portal blood flow (PBF) and hepatic artery blood flow (HABF) (Doppler-Ultrasound) were measured before and 30 minutes after receiving a standard mixed liquid meal. In 10 the HVPG changes were also measured. RESULTS: Post-prandial hyperemia was accompanied by a marked increase in liver stiffness (+27±33%; p<0.0001). Changes in liver stiffness did not correlate with PBF changes, but directly correlated with HABF changes (r = 0.658; p = 0.002). After the meal, those patients showing a decrease in HABF (n = 13) had a less marked increase of liver stiffness as compared to patients in whom HABF increased (n = 6; +12±21% vs. +62±29%,p<0.0001). As expected, post-prandial hyperemia was associated with an increase in HVPG (n = 10; +26±13%, p = 0.003), but changes in liver stiffness did not correlate with HVPG changes. CONCLUSIONS: Liver stiffness increases markedly after a liquid test meal in patients with cirrhosis, suggesting that its measurement should be performed in standardized fasting conditions. The hepatic artery buffer response appears an important factor modulating postprandial changes of liver stiffness. The post-prandial increase in HVPG cannot be predicted by changes in liver stiffness.Public Library of Science (PLoS)2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/54883Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0058742PLoS One, 2013, vol. 8, num. 3, p. e58742http://dx.doi.org/10.1371/journal.pone.0058742cc-by (c) Berzigotti, A. et al., 2013http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/548832026-05-27T06:46:51Z
dc.title.none.fl_str_mv Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
title Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
spellingShingle Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
Berzigotti, Annalisa
Cirrosi hepàtica
Hipertensió portal
Assaigs clínics
Hepatic cirrhosis
Portal hypertension
Clinical trials
title_short Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
title_full Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
title_fullStr Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
title_full_unstemmed Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
title_sort Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension
dc.creator.none.fl_str_mv Berzigotti, Annalisa
Gottardi, Andrea de
Vukotic, Ranka
Siramolpiwat, Sith
Abraldes, Juan G.
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author Berzigotti, Annalisa
author_facet Berzigotti, Annalisa
Gottardi, Andrea de
Vukotic, Ranka
Siramolpiwat, Sith
Abraldes, Juan G.
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author_role author
author2 Gottardi, Andrea de
Vukotic, Ranka
Siramolpiwat, Sith
Abraldes, Juan G.
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Cirrosi hepàtica
Hipertensió portal
Assaigs clínics
Hepatic cirrhosis
Portal hypertension
Clinical trials
topic Cirrosi hepàtica
Hipertensió portal
Assaigs clínics
Hepatic cirrhosis
Portal hypertension
Clinical trials
description BACKGROUND AND AIMS: Liver stiffness is increasingly used in the non-invasive evaluation of chronic liver diseases. Liver stiffness correlates with hepatic venous pressure gradient (HVPG) in patients with cirrhosis and holds prognostic value in this population. Hence, accuracy in its measurement is needed. Several factors independent of fibrosis influence liver stiffness, but there is insufficient information on whether meal ingestion modifies liver stiffness in cirrhosis. We investigated the changes in liver stiffness occurring after the ingestion of a liquid standard test meal in this population. METHODS: In 19 patients with cirrhosis and esophageal varices (9 alcoholic, 9 HCV-related, 1 NASH; Child score 6.9±1.8), liver stiffness (transient elastography), portal blood flow (PBF) and hepatic artery blood flow (HABF) (Doppler-Ultrasound) were measured before and 30 minutes after receiving a standard mixed liquid meal. In 10 the HVPG changes were also measured. RESULTS: Post-prandial hyperemia was accompanied by a marked increase in liver stiffness (+27±33%; p<0.0001). Changes in liver stiffness did not correlate with PBF changes, but directly correlated with HABF changes (r = 0.658; p = 0.002). After the meal, those patients showing a decrease in HABF (n = 13) had a less marked increase of liver stiffness as compared to patients in whom HABF increased (n = 6; +12±21% vs. +62±29%,p<0.0001). As expected, post-prandial hyperemia was associated with an increase in HVPG (n = 10; +26±13%, p = 0.003), but changes in liver stiffness did not correlate with HVPG changes. CONCLUSIONS: Liver stiffness increases markedly after a liquid test meal in patients with cirrhosis, suggesting that its measurement should be performed in standardized fasting conditions. The hepatic artery buffer response appears an important factor modulating postprandial changes of liver stiffness. The post-prandial increase in HVPG cannot be predicted by changes in liver stiffness.
publishDate 2013
dc.date.none.fl_str_mv 2013
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/54883
url https://hdl.handle.net/2445/54883
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0058742
PLoS One, 2013, vol. 8, num. 3, p. e58742
http://dx.doi.org/10.1371/journal.pone.0058742
dc.rights.none.fl_str_mv cc-by (c) Berzigotti, A. et al., 2013
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Berzigotti, A. et al., 2013
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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