2022
Noninvasive 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 surrogate
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 standardCirrhosisSACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation
Kaplan D, Mehta R, Garcia-Tsao G, Albrecht J, Aytaman A, Baffy G, Bajaj J, Hernaez R, Hunt K, Ioannou G, Johnson K, Kanwal F, Lee T, Monto A, Pandya P, Schaubel D, Taddei T. SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation. Contemporary Clinical Trials 2021, 104: 106367. PMID: 33771685, PMCID: PMC8422958, DOI: 10.1016/j.cct.2021.106367.Peer-Reviewed Original ResearchConceptsHepatic decompensationPortal hypertensionEvents of decompensationHepatic decompensation eventsLiver-related deathSignificant portal hypertensionAcceptable safety profileProspective human studiesRole of statinsChronic liver diseaseClasses of medicationsPatient-reported outcomesDevelopment of decompensationEffect of simvastatinVA Medical CenterCompensated cirrhosisDecompensation eventsStatin therapyVariceal hemorrhageCirrhotic patientsStandard therapyVascular reactivityExert pleiotropic effectsLiver diseaseRetrospective studySleep Disturbance Is Associated With the Presence of Portosystemic Collaterals in Patients With Compensated Cirrhosis
Balakrishnan M, Falker C, Conley S, Ciarleglio M, Deng Y, Redeker NS, Garcia‐Tsao G. Sleep Disturbance Is Associated With the Presence of Portosystemic Collaterals in Patients With Compensated Cirrhosis. Hepatology Communications 2021, 5: 491-501. PMID: 33681681, PMCID: PMC7917284, DOI: 10.1002/hep4.1636.Peer-Reviewed Original ResearchConceptsPortosystemic collateralsSleep disturbancesCompensated cirrhosisSleep fragmentationSleep characteristicsHigher international normalized ratioPittsburgh Sleep Quality IndexLower total sleep timeMultivariable linear regression analysisSignificant portal hypertensionGroup of patientsInternational normalized ratioEpworth Sleepiness ScaleSleep Quality IndexGreater sleep fragmentationCross-sectional studyMore sleep disturbancesMore sleep fragmentationTotal sleep timeLower sleep efficiencyPresence of collateralsCollateral presencePortal hypertensionLow albuminExcessive daytime
2020
Ordinal Outcomes Are Superior to Binary Outcomes for Designing and Evaluating Clinical Trials in Compensated Cirrhosis
D’Amico G, Abraldes JG, Rebora P, Valsecchi MG, Garcia‐Tsao G. Ordinal Outcomes Are Superior to Binary Outcomes for Designing and Evaluating Clinical Trials in Compensated Cirrhosis. Hepatology 2020, 72: 1029-1042. PMID: 31837238, PMCID: PMC11090179, DOI: 10.1002/hep.31070.Peer-Reviewed Original ResearchConceptsClinical trialsGrade 1Prevention of decompensationBaseline platelet countDevelopment of varicesSignificant outcome differencesLow baseline riskPrimary therapeutic targetCirrhosis decompensationCompensated cirrhosisInception cohortComposite endpointEsophageal varicesPlatelet countBinary outcomesDisease progressionSignificant treatment effectBaseline riskGrade 3Sample sizeOutcome differencesTherapeutic targetDecompensationGrade 2Larger sample sizeSu1696 SPLEEN STIFFNESS MEASUREMENTS (SSM) IN THE IDENTIFICATION OF CLINICALLY-SIGNIFICANT PORTAL HYPERTENSION (CSPH) IN PATIENTS WITH COMPENSATED CIRRHOSIS.
Ortiz G, Palumbo C, Sayyar M, Balakrishnan M, Mohanty A, Garcia-Tsao G. Su1696 SPLEEN STIFFNESS MEASUREMENTS (SSM) IN THE IDENTIFICATION OF CLINICALLY-SIGNIFICANT PORTAL HYPERTENSION (CSPH) IN PATIENTS WITH COMPENSATED CIRRHOSIS. Gastroenterology 2020, 158: s-1385. DOI: 10.1016/s0016-5085(20)34131-7.Peer-Reviewed Original Research
2019
Emricasan (IDN‐6556) Lowers Portal Pressure in Patients With Compensated Cirrhosis and Severe Portal Hypertension
Garcia‐Tsao G, Fuchs M, Shiffman M, Borg BB, Pyrsopoulos N, Shetty K, Gallegos‐Orozco J, Reddy KR, Feyssa E, Chan JL, Yamashita M, Robinson JM, Spada AP, Hagerty DT, Bosch J. Emricasan (IDN‐6556) Lowers Portal Pressure in Patients With Compensated Cirrhosis and Severe Portal Hypertension. Hepatology 2019, 69: 717-728. PMID: 30063802, PMCID: PMC6587783, DOI: 10.1002/hep.30199.Peer-Reviewed Original ResearchConceptsSevere portal hypertensionPortal hypertensionAlanine aminotransferaseCompensated cirrhosisEnd-stage liver disease (MELD) scoreAspartate aminotransferaseAST/alanine aminotransferaseChild class ALiver Disease scoreOpen-label studyNonserious adverse eventsPortal venous inflowAnti-inflammatory effectsHepatitis C virusSplanchnic vasodilationAdverse eventsHVPG measurementIntrahepatic inflammationPortal pressureBlood pressureCirrhosis etiologyMedian ageNonalcoholic steatohepatitisVenous inflowSignificant changes
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 conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatientsValidating, deconstructing and refining Baveno criteria for ruling out high‐risk varices in patients with compensated cirrhosis
Jangouk P, Turco L, De Oliveira A, Schepis F, Villa E, Garcia‐Tsao G. Validating, deconstructing and refining Baveno criteria for ruling out high‐risk varices in patients with compensated cirrhosis. Liver International 2017, 37: 1177-1183. PMID: 28160373, PMCID: PMC5511584, DOI: 10.1111/liv.13379.Peer-Reviewed Original ResearchConceptsHigh-risk varicesNegative predictive valueBaveno VI criteriaLiver stiffnessBaveno criteriaPredictive valueItalian cohortPlatelet countNon-invasive criteriaCohort of patientsNumber of endoscopiesUnnecessary endoscopiesCompensated cirrhosisPrimary prophylaxisRetrospective studyUS cohortVariceal screeningTransient elastographyVaricesHigh riskLow prevalenceCirrhosisPatientsEndoscopyClinical diagnosis
2015
231/356 Statin Use and the Risk of Decompensation and Death in Veterans With Hepatitis C-Related Compensated Cirrhosis
Mohanty A, Tate J, Garcia-Tsao G. 231/356 Statin Use and the Risk of Decompensation and Death in Veterans With Hepatitis C-Related Compensated Cirrhosis. Gastroenterology 2015, 148: s-972-s-973. DOI: 10.1016/s0016-5085(15)33322-9.Peer-Reviewed Original Research
2011
Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis
Berzigotti A, Garcia‐Tsao G, Bosch J, Grace ND, Burroughs AK, Morillas R, Escorsell A, Garcia‐Pagan J, Patch D, Matloff DS, Groszmann RJ, Group T. Obesity is an independent risk factor for clinical decompensation in patients with cirrhosis. Hepatology 2011, 54: 555-561. PMID: 21567436, PMCID: PMC3144991, DOI: 10.1002/hep.24418.Peer-Reviewed Original ResearchConceptsBody mass indexClinical decompensationPortal pressureBMI groupsNormal body mass indexRole of obesityChronic viral hepatitisIndependent risk factorSubset of patientsValuable therapeutic measureActuarial probabilityCompensated cirrhosisViral hepatitisAggressive courseIndependent predictorsMass indexRandomized trialsLiver functionPatient populationRisk factorsTherapeutic measuresStudy populationCirrhosisTreatment groupsPatients
2010
Sildenafil 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
2005
Ascites
Kbalid S, Garcia-Tsao G. Ascites. Clinical Gastroenterology 2005, 285-299. DOI: 10.1007/978-1-59259-885-4_19.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSevere ovarian hyperstimulation syndromeOvarian hyperstimulation syndromeCause of ascitesAccumulation of fluidHyperstimulation syndromePeritoneal malignancyCompensated cirrhosisPeritoneal tuberculosisPortal hypertensionCommon complicationCardiac failureProspective studyCommon causeDifferential diagnosisPeritoneal cavityAscitesCirrhosisCumulative probabilityPatientsCauseHypertensionComplicationsMalignancySyndromeEtiology
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
1997
Doppler ultrasound in the evaluation of cirrhotic patients: The prevalence of intrahepatic arteriovenous shunting, and implications for diagnosis of hepatocellular carcinoma
Taylor C, Garcia-Tsao G, Henson B, Case C, Taylor K. Doppler ultrasound in the evaluation of cirrhotic patients: The prevalence of intrahepatic arteriovenous shunting, and implications for diagnosis of hepatocellular carcinoma. Ultrasound In Medicine & Biology 1997, 23: 1155-1163. PMID: 9372563, DOI: 10.1016/s0301-5629(97)00028-8.Peer-Reviewed Original ResearchConceptsArteriovenous shuntingCirrhotic patientsHepatocellular carcinomaLiver lesionsShunt velocityHepatic arteriovenous shuntingIntrahepatic arteriovenous shuntingMalignant hepatic lesionsFocal liver lesionsReal-time ultrasoundCompensated cirrhoticsFocal fatCompensated cirrhosisFatty infiltrationMalignancy increasesUS findingsDoppler ultrasoundHepatic lesionsDoppler USFocal massPatientsMalignancyLesionsPrevalenceCarcinoma