2023
Machine learning liver histology scores correlate with portal hypertension assessments in nonalcoholic steatohepatitis cirrhosis
Noureddin M, Goodman Z, Tai D, Chng E, Ren Y, Boudes P, Shlevin H, Garcia‐Tsao G, Harrison S, Chalasani N. Machine learning liver histology scores correlate with portal hypertension assessments in nonalcoholic steatohepatitis cirrhosis. Alimentary Pharmacology & Therapeutics 2023, 57: 409-417. PMID: 36647687, PMCID: PMC10107331, DOI: 10.1111/apt.17363.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPresence of varicesEnd of treatmentValidation cohortLiver histology scoresPhase 2b trialPrimary efficacy endpointVenous pressure gradientDevelopment of varicesNonalcoholic steatohepatitis cirrhosisImportant histologic featuresImportant clinical relevanceHVPG changesEfficacy endpointHVPG measurementLiver histologyUpper endoscopyLiver biopsyLiver outcomesHistologic variablesNASH cirrhosisHistologic featuresHypertension assessmentCirrhosis (HALT-C) TrialClinical trials
2022
Endovascular Assessment of Liver Hemodynamics in Patients with Cirrhosis Complicated by Portal Hypertension
Ferral H, Schepis F, Gaba R, Garcia-Tsao G, Zanetto A, Perez-Campuzano V, Haskal Z, Garcia-Pagan J. Endovascular Assessment of Liver Hemodynamics in Patients with Cirrhosis Complicated by Portal Hypertension. Journal Of Vascular And Interventional Radiology 2022, 34: 327-336. PMID: 36516940, DOI: 10.1016/j.jvir.2022.12.014.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHepatic venous pressure gradientPortal hypertensionPortosystemic pressure gradientTransjugular intrahepatic portosystemic shuntVenous pressure gradientIntrahepatic portosystemic shuntSurgical patientsRisk stratificationHemodynamic measurementsPortosystemic shuntLiver hemodynamicsTreatment optionsShunt diameterMeticulous techniquePatientsClinical practiceGold standardHypertensionManagement optionsPressure gradientCirrhosisComplicatedHemodynamicsOptionsShuntNoninvasive predictors of clinically significant portal hypertension in NASH cirrhosis: Validation of ANTICIPATE models and development of a lab‐based model
Rabiee A, Deng Y, Ciarleglio M, Chan JL, Pons M, Genesca J, Garcia‐Tsao G. Noninvasive predictors of clinically significant portal hypertension in NASH cirrhosis: Validation of ANTICIPATE models and development of a lab‐based model. Hepatology Communications 2022, 6: 3324-3334. PMID: 36214066, PMCID: PMC9701481, DOI: 10.1002/hep4.2091.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientSignificant portal hypertensionTransient elastographyNASH cirrhosisPortal hypertensionFibrosis-4 indexPresence of CSPHVenous pressure gradientNonalcoholic steatohepatitis cirrhosisBody mass indexLiver stiffness measurementGood calibrationCompensated cirrhosisFIB-4Mass indexPlatelet countValidation cohortNoninvasive predictorTraining cohortBaseline riskLaboratory valuesCirrhosisHigh riskSeparate cohortNoninvasive surrogateAscites and its complications
García‐Tsao G. Ascites and its complications. 2022, 2024-2043. DOI: 10.1002/9781119600206.ch98.Peer-Reviewed Original ResearchHepatic sinusoidal pressureHepatic venous pressure gradientSerum-ascites albumin gradientAcute kidney injuryPresence of ascitesVenous pressure gradientMain pathogenic mechanismPredominance of neutrophilsSinusoidal pressureAccumulation of fluidAbdominal ultrasonographyKidney injurySodium restrictionCirrhotic patientsPortal pressureSodium retentionDecompensated stageInflammatory processPolymorphonuclear cellsPeritoneal cavityAscites albuminAscitic fluidAscitesCirrhosisPathogenic mechanisms
2021
Baveno VII – Renewing consensus in portal hypertension
de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Faculty B, Abraldes J, Albillos A, Baiges A, Bajaj J, Bañares R, Barrufet M, Benajiba L, Berzigotti A, Bureau C, Calvaruso V, Cardenas A, D’Amico G, De Gottardi A, Dell’Era A, Escorsell A, Fallowfield J, Ferral H, Francque S, Gaba R, Garcia-Pagàn J, Genescà J, Rodrigues S, Gracia-Sancho J, Han G, Hernandez-Gea V, Jia J, Kiladjian J, Krag A, Laleman W, La Mura V, Lens S, Luo X, Mandorfer M, Murad S, Paradis V, Patch D, Piano S, Pinzani M, Plessier A, Primignani M, Procopet B, Rautou P, Rudler M, Sarin S, Schepis F, Senzolo M, Shah V, Shukla A, Tandon P, Tellez L, Thabut D, Thiele M, Trebicka J, Tripathi D, Tsochatzis E, Turco L, Turon F, Valla D, Villanueva C, Wanless I, Yoshiji H. Baveno VII – Renewing consensus in portal hypertension. Journal Of Hepatology 2021, 76: 959-974. PMID: 35120736, PMCID: PMC11090185, DOI: 10.1016/j.jhep.2021.12.022.Peer-Reviewed Original ResearchConceptsPortal hypertensionAdvanced chronic liver diseaseHepatic venous pressure gradientAcute bleeding episodeSignificant portal hypertensionVenous pressure gradientChronic liver diseaseSplanchnic vein thrombosisCourse of cirrhosisRisk of deathNon-invasive toolBleeding episodesCompensated cirrhosisFurther decompensationVein thrombosisLiver diseaseBaveno VIVascular disordersFirst episodeHypertensionPersonalized careMedical literatureTherapeutic needsGold standardCirrhosis
2019
Author response to Letter to the Editor: ‘Dynamics of platelet count after sustained virologic response do not mirror those of hepatic venous pressure gradient’
Ortiz GA, Sayyar M, Garcia‐Tsao G. Author response to Letter to the Editor: ‘Dynamics of platelet count after sustained virologic response do not mirror those of hepatic venous pressure gradient’. Liver International 2019, 40: 990-991. PMID: 31749290, DOI: 10.1111/liv.14302.Commentaries, Editorials and LettersConceptsHepatic venous pressure gradientSustained virologic responseVenous pressure gradientVirologic responsePlatelet count
2017
Primary and secondary prophylaxis of esophageal variceal bleeding
Jangouk P, Garcia-Tsao G. Primary and secondary prophylaxis of esophageal variceal bleeding. Techniques And Innovations In Gastrointestinal Endoscopy 2017, 19: 84-89. DOI: 10.1016/j.tgie.2017.03.004.Peer-Reviewed Educational MaterialsHepatic venous pressure gradientPortal hypertensionVariceal hemorrhageHigh riskComplications of cirrhosisSignificant portal hypertensionVenous pressure gradientDevelopment of varicesEsophageal variceal bleedingIsolated complicationSecondary prophylaxisCompensated cirrhosisDirect complicationsVariceal bleedingClinical decompensationPortal pressureEsophageal varicesCompensated stageChronic conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatientsLBP-523 A reduction in the hepatic venous pressure gradient (HVPG) prevents clinical outcomes in compensated and decompensated cirrhosis: a meta-analysis
Turco L, Villanueva C, La Mura V, Garcia-Pagan J, Reiberger T, Genesca J, Groszmann R, Sharma B, Merkel C, Bureau C, Alvarado E, Abraldes J, Albillos A, Banares R, Peck-Radosavljevic M, Augustin S, Sarin S, Bosch J, Garcia-Tsao G. LBP-523 A reduction in the hepatic venous pressure gradient (HVPG) prevents clinical outcomes in compensated and decompensated cirrhosis: a meta-analysis. Journal Of Hepatology 2017, 66: s103-s104. DOI: 10.1016/s0168-8278(17)30468-3.Peer-Reviewed Original Research
2016
Impact of Treatment of Non-bleeding Complications of Cirrhosis on the Risk of Variceal Bleeding
Augustin S, Albillos A, Ripoll C, Abraldes J, Salerno F, Moreau R, Reiberger T, Garcia-Tsao G. Impact of Treatment of Non-bleeding Complications of Cirrhosis on the Risk of Variceal Bleeding. 2016, 341-353. DOI: 10.1007/978-3-319-23018-4_34.Peer-Reviewed Original ResearchHepatic venous pressure gradientVariceal hemorrhageVariceal bleedingPortal pressureAlpha-1 adrenergic antagonistNon-bleeding complicationsVenous pressure gradientPortal blood flowClinical trial recordsImpact of treatmentDecompensated cirrhosisOral anticoagulantsRefractory ascitesCirrhotic patientsClinical decompensationCohort studyArterial pressureVasoactive drugsRandomized trialsLarge trialsCardiac outputProphylactic useAdrenergic antagonistsClinical dataBlood flow
2015
Natural History of Cirrhosis
Garcia-Tsao G. Natural History of Cirrhosis. 2015, 13-20. DOI: 10.1007/978-3-319-13614-1_2.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPrognostic stageHepatic venous pressure gradientNatural historyDifferent prognostic stagesRecurrent variceal hemorrhageVenous pressure gradientMulti-organ failureAbsence of varicesHepatorenal syndromeDecompensated cirrhosisRefractory ascitesVariceal hemorrhageHepatic encephalopathyLiver failureSpecific complicationsWorse prognosisDecompensated stageReversible diseaseCirrhosisPatientsVaricesPrognosisDecompensationAscitesComplications
2014
Prognostic Factors in Compensated and Decompensated Cirrhosis
Ripoll C, Zipprich A, Garcia-Tsao G. Prognostic Factors in Compensated and Decompensated Cirrhosis. Current Hepatology Reports 2014, 13: 171-179. DOI: 10.1007/s11901-014-0234-6.Peer-Reviewed Original ResearchHepatic venous pressure gradientPortal hypertensionPredictive factorsSignificant portal hypertensionSpecific predictive factorsVenous pressure gradientSerum albumin levelAlternative non-invasive methodDecompensated diseaseMELD scoreClinical decompensationFurther decompensationAlbumin levelsPrognostic factorsNon-invasive methodCirrhosisInvasive proceduresDecompensationDeathHypertensionNumber of studiesImportant predictorChildren's scoresRecent studiesScores
2012
Prognostic indicators of survival in patients with compensated and decompensated cirrhosis
Zipprich A, Garcia‐Tsao G, Rogowski S, Fleig WE, Seufferlein T, Dollinger MM. Prognostic indicators of survival in patients with compensated and decompensated cirrhosis. Liver International 2012, 32: 1407-1414. PMID: 22679906, PMCID: PMC3713489, DOI: 10.1111/j.1478-3231.2012.02830.x.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPredictors of deathCompensated patientsPortal hypertensionPrognostic valueComplications of cirrhosisSignificant portal hypertensionStage 2 patientsVenous pressure gradientDecompensated patientsSystemic haemodynamicsVariceal hemorrhagePortal pressureIndependent predictorsMultivariable analysisClinical eventsDecompensated stagePrognostic indicatorStaging systemLonger survivalBACKGROUND/CirrhosisPatientsSurvival rateAnalyse survival
2010
Hepatic Venous Pressure Gradient, Biopsy or Both?
Garcia‐Tsao G. Hepatic Venous Pressure Gradient, Biopsy or Both? 2010, 7-17. DOI: 10.1002/9781444393989.ch1.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSildenafil Has No Effect on Portal Pressure but Lowers Arterial Pressure in Patients With Compensated Cirrhosis
Tandon P, Inayat I, Tal M, Spector M, Shea M, Groszmann RJ, Garcia–Tsao G. Sildenafil Has No Effect on Portal Pressure but Lowers Arterial Pressure in Patients With Compensated Cirrhosis. Clinical Gastroenterology And Hepatology 2010, 8: 546-549. PMID: 20144739, PMCID: PMC2879450, DOI: 10.1016/j.cgh.2010.01.017.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientMean arterial pressurePortal pressureArterial pressureHeart rateBaseline hepatic venous pressure gradientMedian mean arterial pressureOpen-label pilot studyPhosphodiesterase-5 inhibitor sildenafilSystemic vasodilatory effectVenous pressure gradientEffect of sildenafilPortal venous inflowIntrahepatic resistanceOral sildenafilCompensated cirrhosisCirrhotic patientsVasodilatory effectChild APortal hemodynamicsErectile dysfunctionVenous inflowInhibitor sildenafilTherapeutic dosesPatients
2009
Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia–Tsao G, Bosch J, Burroughs AK, Ripoll C, Maurer R, Planas R, Escorsell A, Garcia–Pagan J, Patch D, Matloff DS, Makuch R, Rendon G, Group P. Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis. Clinical Gastroenterology And Hepatology 2009, 7: 689-695. PMID: 19281860, PMCID: PMC4545534, DOI: 10.1016/j.cgh.2009.02.021.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientHematologic indicesCompensated cirrhosisBaseline hepatic venous pressure gradientWhite blood cell countChild-Pugh scorePredictors of deathPrimary end pointVenous pressure gradientDevelopment of varicesKaplan-Meier analysisBlood cell countCombination of leukopeniaBaseline thrombocytopeniaVariceal bleedingClinical decompensationEsophageal varicesPrognostic significanceTransplant surgeryClinical significanceLeukopeniaThrombocytopeniaCirrhosisCell countVarices
2007
Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia‐Tsao G, Bosch J, Burroughs AK, Maurer R, Planas R, Escorsell A, Garcia‐Pagan J, Patch D, Matloff DS, Makuch R, Group P. Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis. Hepatology 2007, 47: 153-159. PMID: 18161700, DOI: 10.1002/hep.21941.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPresence of GEVsGastroesophageal varicesPlatelet countPortal hypertensionMild portal hypertensionSpecific platelet countDouble-blind trialVenous pressure gradientTime of endoscopyHVPG changesCompensated cirrhosisHVPG measurementNoninvasive testsCurrent guidelinesNoninvasive markerPatientsSecondary analysisLongitudinal evaluationCirrhosisEsophagogastroduodenoscopyHypertensionVaricesPresent longitudinal studyLongitudinal studyHepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis
Ripoll C, Groszmann R, Garcia–Tsao G, Grace N, Burroughs A, Planas R, Escorsell A, Garcia–Pagan J, Makuch R, Patch D, Matloff DS, Bosch J, Group P. Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis. Gastroenterology 2007, 133: 481-488. PMID: 17681169, DOI: 10.1053/j.gastro.2007.05.024.Peer-Reviewed Original ResearchMeSH KeywordsAgedAscitesEsophageal and Gastric VaricesFemaleFollow-Up StudiesGastrointestinal HemorrhageHepatic EncephalopathyHumansHypertension, PortalKaplan-Meier EstimateLiver CirrhosisMaleMiddle AgedPortal PressurePredictive Value of TestsPrognosisProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsROC CurveSensitivity and SpecificitySeverity of Illness IndexTime FactorsConceptsHepatic venous pressure gradientVenous pressure gradientClinical decompensationPortal hypertensionMedian hepatic venous pressure gradientEnd-stage liver diseaseDiagnostic capacityBaseline laboratory testsPredictors of decompensationChild-Pugh scoreDevelopment of varicesMedical record reviewEnd of studyMedian followCompensated cirrhosisLiver transplantationLiver diseaseRecord reviewStudy terminationDecompensationPatientsCirrhosisMultivariate analysisVaricesHypertension
2004
Treatment of acute variceal bleeding: general management and prevention of infections
Garcia-Tsao G. Treatment of acute variceal bleeding: general management and prevention of infections. 2004, 233-240. DOI: 10.1007/978-94-007-1042-9_25.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsVariceal bleedingCirrhotic patientsPoor outcomePredictive factorsHepatic venous pressure gradientUpper gastrointestinal bleeding episodesActive variceal bleedingEarly recurrent bleedingAcute variceal bleedingVenous pressure gradientGastrointestinal bleeding episodesPrevention of infectionAlcoholic etiologyBleeding episodesGastrointestinal hemorrhageRecurrent bleedingRenal dysfunctionVariceal hemorrhageLiver dysfunctionEsophageal varicesUncontrolled bleedingDiagnostic endoscopyHepatocellular carcinomaBleedingPatients
2002
Assessment of therapeutic benefit of antiviral therapy in chronic hepatitis C: is hepatic venous pressure gradient a better end point?
Burroughs A, Groszmann R, Bosch J, Grace N, Garcia-Tsao G, Patch D, Garcia-Pagan J, Dagher L. Assessment of therapeutic benefit of antiviral therapy in chronic hepatitis C: is hepatic venous pressure gradient a better end point? Gut 2002, 50: 425. PMID: 11839726, PMCID: PMC1773121, DOI: 10.1136/gut.50.3.425.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientChronic hepatitis CVenous pressure gradientHepatitis CAntiviral therapyEnd pointChronic hepatitis C.Major healthcare problemBest end pointHepatitis C.HVPG measurementTherapeutic benefitTherapeutic evaluationTherapyHealthcare problemPatientsPressure gradientResponse
1999
Low‐dose midazolam sedation: An option for patients undergoing serial hepatic venous pressure measurements
Steinlauf A, Garcia‐Tsao G, Zakko M, Dickey K, Gupta T, Groszmann R. Low‐dose midazolam sedation: An option for patients undergoing serial hepatic venous pressure measurements. Hepatology 1999, 29: 1070-1073. PMID: 10094948, DOI: 10.1002/hep.510290421.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientHepatic venous pressure measurementsWedged hepatic venous pressureFree hepatic venous pressureVenous pressure measurementsHepatic venous pressurePortal hypertensionVenous pressureSerial measurementsPatient comfortVenous pressure gradientDoses of midazolamDouble-blind studyDose of midazolamHigh-dose midazolamEffects of midazolamEffects of sedativesPortal pressure measurementsPressure measurementsCompensated cirrhosisVariceal hemorrhageCirrhotic patientsPharmacological therapyMidazolam sedationPrognostic index