Abstract:
BACKGROUND:Variceal bleeding is a major complication of portal hypertension, which is associated with significant mortality. Moreover, patients surviving a variceal bleeding episode have very high risk of rebleeding, which is associated with mortality as high as that of the first bleed. Because of this, prevention of bleeding from gastroesophageal varices has been one of the main therapeutic goals since the advent of the first effective therapies for portal hypertension. AIM:This review deals with the present day state-of-the-art pharmacological prevention of variceal bleeding in primary and secondary prophylaxis. RESULTS:Pharmacological therapy aims to decrease portal pressure (PP) by acting on the pathophysiological mechanisms of portal hypertension such as increased hepatic vascular tone and splanchnic vasodilatation. Propranolol and nadolol block the beta-1 in the heart and the peripheral beta-2 adrenergic receptors. Beta-1 blockade of cardiac receptors reduces heart rate and cardiac output and subsequently decreases flow into splanchnic circulation. Beta-2 blockade leads to unopposed alpha-1 adrenergic activity that causes splanchnic vasoconstriction and reduction of portal inflow. Both effects contribute to reduction in PP. Carvedilol is more powerful in reducing hepatic venous pressure gradient (HVPG) than traditional nonselective beta-blockers (NSBBs) and achieves good hemodynamic response in nearly 75 % of cases. Simvastatin and atorvastatin improve endothelial dysfunction mainly by enhancing endothelial nitric oxide synthase (eNOS) expression and phosphorylation and NO production. In addition, statins deactivate hepatic stellate cells and ameliorate hepatic fibrogenesis. These effects cause a decrease in HVPG and improve liver microcirculation and hepatocyte perfusion in patients with cirrhosis. In addition, several promising drugs under development may change the management of portal hypertension in the coming years. CONCLUSION:This review provides a background on the most important aspects of the treatment of portal hypertension in patients with compensated and decompensated liver cirrhosis. However, despite the great improvement in the prevention of variceal bleeding over the last years, further therapeutic options are needed.
journal_name
Hepatol Intjournal_title
Hepatology internationalauthors
Baiges A,Hernández-Gea V,Bosch Jdoi
10.1007/s12072-017-9833-ysubject
Has Abstractpub_date
2018-02-01 00:00:00pages
68-80issue
Suppl 1eissn
1936-0533issn
1936-0541pii
10.1007/s12072-017-9833-yjournal_volume
12pub_type
杂志文章,评审abstract:BACKGROUND AND AIMS:Acute-on-chronic liver failure (ACLF) is associated with a high mortality rate in the absence of liver transplantation. There is limited data on predictors of survival in ACLF in children. Therefore, we prospectively studied the predictors of outcome of ACLF in children. METHODS:A prospective evalu...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-010-9217-z
更新日期:2011-06-01 00:00:00
abstract::The presence of hepatic encephalopathy (HE) within 4 weeks is part of the criteria for defining acute-on-chronic liver failure (ACLF). The pathophysiology of HE is complex, and hyperammonemia and cerebral hemodynamic dysfunction appear to be central in the pathogenesis of encephalopathy. Recent data also suggest that ...
journal_title:Hepatology international
pub_type: 杂志文章,评审
doi:10.1007/s12072-015-9626-0
更新日期:2015-10-01 00:00:00
abstract::Background and aims The aims of this study were to evaluate a preventive effect on collateral venous circulation of long-term administration of propranolol in intrahepatic portal hypertensive rats. Methods Eighty-six Sprague-Dawley rats were allocated to two models of hepatic fibrosis, bile duct-ligated (BDL) induced ...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-008-9070-5
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:To analyze the prognostic factors for the patients with lung metastases from hepatocellular carcinoma (HCC). METHODS AND MATERIALS:One hundred and five patients with lung metastases from HCC were analyzed retrospectively. We analyzed the impact factors, including the gender, age, liver function, serum AFP and ...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-008-9052-7
更新日期:2008-06-01 00:00:00
abstract:PURPOSE:Transcriptional silencing of tumor suppressor genes associated with DNA hypermethylation has been known as a hallmark of human cancer. In this study, we revealed that a local anesthetic, procaine (PCA), possessed growth-inhibitory and demethylating effect on human hepatoma cells in vitro and in vivo. METHODS:T...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-007-9014-5
更新日期:2007-09-01 00:00:00
abstract::Hepatitis due to hepatitis B virus reactivation after cytotoxic or immunosuppressive therapy is a serious cause of liver-related morbidity and mortality. With the characterization of the underlying pathogenesis, much progress in the management of this important clinical problem has been made in the past 2 decades. By ...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-008-9056-3
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the association of the Laennec staging system with degree of cirrhosis, clinical stage and liver function. METHODS:Liver biopsy was performed for 30 patients with hepatitis B cirrhosis to test the content of hydroxyproline in hepatic tissue, judge the degree of cirrh...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-015-9648-7
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Type II mixed cryoglobulinemia (MC) is a systemic vasculitis usually associated with hepatitis C virus (HCV). The present trial was performed to investigate the efficacy of therapy with pegylated interferon alfa-2a (PEG-IFN alfa-2a) plus ribavirin in patients with HCV-related MC vasculitis and evaluate the fa...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-011-9303-x
更新日期:2012-06-01 00:00:00
abstract::Reactive oxygen and nitrogen species (ROS and RNS) are produced by metabolism of normal cells. However, in liver diseases, redox is increased thereby damaging the hepatic tissue; the capability of ethanol to increase both ROS/RNS and peroxidation of lipids, DNA, and proteins was demonstrated in a variety of systems, c...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-009-9158-6
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:Despite improvements in immunosuppressive therapy, acute cellular rejection (ACR) remains an important cause of graft loss in patients undergoing liver transplantation. Recently, associations between cytokine gene polymorphisms in recipients and the occurrence of ACR have been reported. However, most studies di...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-013-9443-2
更新日期:2013-07-01 00:00:00
abstract:GOALS:The aim of our study is to assess the prevalence of nonalcoholic fatty liver disease (NAFLD) and advanced hepatic fibrosis in patients with type 1 diabetes (T1D) using simple noninvasive scores. BACKGROUND:There is paucity of data on the prevalence of NAFLD in T1D. Moreover, T1D could be a risk factor for advanc...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-017-9840-z
更新日期:2018-01-01 00:00:00
abstract::The bone marrow contains stem cells that have the potential to differentiate into a variety of organ-specific mature cells, including the liver and the pancreas. Recently, the origin of hepatic progenitors and hepatocytes was identified to be the bone marrow. However, evidence that describes which cells, among all bon...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-007-9031-4
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND AND AIMS:Coronavirus disease 2019 (COVID-19) pandemic is ongoing. Except for lung injury, it is possible that COVID-19 patients develop liver injury. Thus, we conducted a systematic review and meta-analysis to explore the incidence, risk factors, and prognosis of abnormal liver biochemical tests in COVID-19 ...
journal_title:Hepatology international
pub_type: 杂志文章,meta分析
doi:10.1007/s12072-020-10074-6
更新日期:2020-09-01 00:00:00
abstract::The Chinese Society of Hepatology developed the current guidelines for the Management of Ascites and Its Related Complications in Cirrhosis based on the published evidences and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of cirrhotic ascites emphasizing a step-wis...
journal_title:Hepatology international
pub_type: 社论,实务指引
doi:10.1007/s12072-018-09923-2
更新日期:2019-01-01 00:00:00
abstract:PURPOSE:The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party to develop a consensus cost-effectiveness model for treatment of Hepatitis B in Asia Pacific countries in March 2010. METHODS:The working party consisted of expert hepatologists, virologists and epidemiolog...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-014-9549-1
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The relationship between chronic hepatitis B virus (HBV) infection and fatty liver in patients remains unclear. Although high-fat diets-induced hepatic steatosis was proved to reduce HBV replication in transgenic mice, the interplay between HBV and fatty liver in immunocompetent mouse model is yet to be eluci...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-018-9877-7
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND AND AIMS:The liver plays a key role in the storage, metabolism and homeostasis of fat-soluble vitamins. We investigated the relation of Vitamin(Vit)A/D/E serum levels with severity of liver disease and portal hypertension (PHT). METHODS:VitA/D/E serum levels were assessed in 234 patients with advanced chron...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-020-10112-3
更新日期:2020-12-01 00:00:00
abstract::Drug-induced liver injury (DILI) is an important clinical problem, which has received more attention in recent decades. It can be induced by small chemical molecules, biological agents, traditional Chinese medicines (TCM), natural medicines (NM), health products (HP), and dietary supplements (DS). Idiosyncratic DILI i...
journal_title:Hepatology international
pub_type: 社论
doi:10.1007/s12072-017-9793-2
更新日期:2017-05-01 00:00:00
abstract::Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic ...
journal_title:Hepatology international
pub_type: 杂志文章,评审
doi:10.1007/s12072-017-9826-x
更新日期:2018-02-01 00:00:00
abstract::Patients (85%) with hepatocellular adenoma (HCA) are women taking oral contraceptives. They can be divided into four subgroups according to their genotype/phenotype features. (1) Hepatocyte nuclear factor 1alpha (HNF1alpha) biallelic somatic mutations are observed in 35% of the HCA cases. It occurs in almost all cases...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-008-9075-0
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND AND AIMS:Ultrasonography is the most frequently used modality in surveillance for HCC among patients with chronic hepatitis C. However, the optimal surveillance interval is still controversial and the usefulness of supplementary tumor marker determination has not been confirmed. METHODS:A total of 243 cases...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-009-9145-y
更新日期:2009-12-01 00:00:00
abstract::The term nonalcoholic fatty liver disease (NAFLD) comprises a spectrum of increasingly harmful conditions ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) to liver fibrosis and end-stage cirrhosis. NAFLD is the currently most common form of chronic liver disease in both adults and ch...
journal_title:Hepatology international
pub_type: 杂志文章,评审
doi:10.1007/s12072-019-10001-4
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND AND AIMS:The progression of HBsAg-positive chronic hepatitis is insidious and unpredictable. Identification of factors leading to either a benign or more serious clinical outcome may assist in decision making for antiviral therapy. METHODS:From 1989 to 1998, 130 untreated patients with chronic hepatitis wer...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-015-9651-z
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Sorafenib significantly improves survival in patients with advanced hepatocellular carcinoma (HCC). This phase IV study assessed sorafenib efficacy/safety in Taiwanese patients with advanced HCC and Child-Pugh A status. METHODS:All patients received 400 mg sorafenib BID. Safety, efficacy, sorafenib pharmaco...
journal_title:Hepatology international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s12072-016-9774-x
更新日期:2017-03-01 00:00:00
abstract::Actinomycotic hepatic abscess was diagnosed in a 46-year-old male driver from Ukraine presenting with the symptoms of malaise, loss of appetite, upper right quadrant pain, weight loss, and night sweats which had been present for last 2 months. Computed tomography (CT) of the abdomen revealed a hypodense mass in the le...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-007-9032-3
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Gut microbiota has been associated with liver cirrhosis and, possibly, hepatic encephalopathy. However, only a few studies have examined the link between mucosa-associated microbiota (MAM) and minimal hepatic encephalopathy (MHE). Our aim was to investigate this relationship. METHODS:Twenty-four pat...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-019-09963-2
更新日期:2019-07-01 00:00:00
abstract:AIMS:Relationships of renal function and liver disease are described in acute and chronic liver failure. The aim of the study is to investigate which relationship, if any, is present between severity of non-alcoholic fatty liver disease (NAFLD), assessed by bright liver score (BLS) versus mild-moderate renal insufficie...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-011-9254-2
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:Either combination treatment or monotherapy using agents with a high genetic barrier are recommended for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). The aim of this study was to compare effect of naïve HBeAg-negative CHB patients with either de novo combination of lamivudine (LAM) and adef...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-010-9243-x
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND AIMS:A discrepancy in virological and biochemical responses may occur throughout interferon-based therapy for hepatitis C virus (HCV). We aimed to explore the risk, associated factors, potential mechanisms, and impact on the treatment outcome of the discrepancy. SUBJECTS AND METHODS:Consecutive 496, chr...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-012-9388-x
更新日期:2013-03-01 00:00:00
abstract::In patients with chronic hepatitis B (CHB), liver fibrosis assessment is essential not only for determining prognosis but also for identifying patients who should receive treatment. Liver biopsy is limited by its invasiveness and sampling error. To explore effective non-invasive methods for liver fibrosis assessment, ...
journal_title:Hepatology international
pub_type: 杂志文章
doi:10.1007/s12072-013-9439-y
更新日期:2013-06-01 00:00:00