2024
CHAPTER 1 Introduction
Ortiz G, Garcia-Tsao G. CHAPTER 1 Introduction. 2024, 1-6. DOI: 10.1016/b978-0-323-87479-3.00010-7.ChaptersChronic liver diseasePortal hypertensionSustained liver injurySignificant portal hypertensionHealth care utilizationHepatic vein catheterizationStaging of fibrosisBurden of diseaseMost complicationsLiver injuryCare utilizationLiver diseaseVein catheterizationCirrhotic stageLiver stiffnessInvasive proceduresTime of interpretationDiffuse depositionSignificant causeAge groupsNoninvasive meansFibrous tissueSmall riskInterobserver variabilityGold standard
2023
Interventional Radiology and Surgical Treatment Options for Non-Cirrhotic Portal Hypertension
Rabiee A, Cornman-Homonoff J, Kunstman J, Garcia-Tsao G, Taddei T. Interventional Radiology and Surgical Treatment Options for Non-Cirrhotic Portal Hypertension. Current Hepatology Reports 2023, 22: 269-275. DOI: 10.1007/s11901-023-00617-4.Peer-Reviewed Original ResearchPortal hypertensionInterventional radiologyNon-cirrhotic portal hypertensionPorto-sinusoidal vascular diseaseHepatic sinusoidal obstruction syndromeAbsence of cirrhosisPortal vein thrombosisSinusoidal obstruction syndromeBudd-Chiari syndromeSurgical treatment optionsHepatic vascular anatomyObstruction syndromeVein thrombosisSurgical treatmentTreatment optionsVascular diseaseImproved outcomesTherapeutic evaluationVascular anatomyHeterogenous groupHypertensionSyndromeDisordersOutcomesTreatmentAASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis
Kaplan D, Ripoll C, Thiele M, Fortune B, Simonetto D, Garcia-Tsao G, Bosch J. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2023, 79: 1180-1211. PMID: 37870298, DOI: 10.1097/hep.0000000000000647.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsUpdate in the Treatment of the Complications of Cirrhosis
Abraldes J, Caraceni P, Ghabril M, Garcia-Tsao G. Update in the Treatment of the Complications of Cirrhosis. Clinical Gastroenterology And Hepatology 2023, 21: 2100-2109. PMID: 36972759, PMCID: PMC11097249, DOI: 10.1016/j.cgh.2023.03.019.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsTransjugular intrahepatic portosystemic shuntVariceal hemorrhageHepatic encephalopathyPre-emptive transjugular intrahepatic portosystemic shuntsAcute variceal hemorrhageCombination of terlipressinAcute kidney injuryComplications of cirrhosisSecond-line treatmentSignificant portal hypertensionFirst-line treatmentLeast common causePrognosis of patientsOrnithine L-aspartatePresence of varicesIntrahepatic portosystemic shuntStandard of careQuality of lifeCyanoacrylate injectionHepatorenal syndromeUncomplicated ascitesKidney injuryPortal hypertensionRefractory ascitesAlbumin use
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 surrogateNonselective Beta‐Blockers in Portal Hypertension: Why, When, and How?
Rabiee A, Garcia‐Tsao G, Tapper EB. Nonselective Beta‐Blockers in Portal Hypertension: Why, When, and How? Clinical Liver Disease 2022, 19: 118-123. PMID: 35355838, PMCID: PMC8958249, DOI: 10.1002/cld.1182.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
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
SGLT2 inhibitors in patients with cirrhosis and diabetes mellitus: A tertiary center cohort study and insights about a potential therapeutic target for portal hypertension
Saffo S, Garcia‐Tsao G, Taddei T. SGLT2 inhibitors in patients with cirrhosis and diabetes mellitus: A tertiary center cohort study and insights about a potential therapeutic target for portal hypertension. Journal Of Diabetes 2020, 13: 265-269. PMID: 33210815, DOI: 10.1111/1753-0407.13136.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBenzhydryl CompoundsCohort StudiesDiabetes Mellitus, Type 2FemaleGlucosidesGlycated HemoglobinHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedOutcome Assessment, Health CarePolyuriaSodium-Glucose Transporter 2 InhibitorsTertiary Care CentersUrinary Tract InfectionsYoung AdultConceptsSGLT2 inhibitorsPortal hypertensionDiabetes mellitusSodium-glucose cotransporter 2 inhibitorsGlucose cotransporter 2 inhibitorsCenter cohort studyCotransporter 2 inhibitorsCohort of patientsPotential therapeutic targetFavorable pleiotropic effectsCohort studyRenal diseaseClinical trialsClinical dataTherapeutic targetPatientsCirrhosisHypertensionMellitusOngoing evaluationInhibitorsPleiotropic effectsCohortDiseaseTrialsSu1696 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
Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis
Sayyar M, Saidi M, Zapatka S, Deng Y, Ciarleglio M, Garcia‐Tsao G. Platelet count increases after viral elimination in chronic HCV, independent of the presence or absence of cirrhosis. Liver International 2019, 39: 2061-2065. PMID: 31365178, PMCID: PMC11340272, DOI: 10.1111/liv.14203.Peer-Reviewed Original ResearchConceptsChronic hepatitis C virusHepatitis C virusPresence of cirrhosisViral eliminationTreatment completionPlatelet countLiver fibrosisNegative HCV RNAAbsence of cirrhosisChronic HCV infectionNon-invasive scoresPlatelet count increaseChronic liver diseaseHCV infectionPortal hypertensionHCV RNAAntiviral treatmentFibrosis scoreLiver diseaseC virusFibrosis stageRetrospective analysisCirrhosisPatientsFibrosisLBO-01-Multicenter, double-blind, placebo-controlled, randomized trial of emricasan in subjects with NASH cirrhosis and severe portal hypertension
Garcia-Tsao G, Bosch J, Kayali Z, Harrison S, Abdelmalek M, Lawitz E, Satapathy S, Ghabril M, Shiffman M, Younes Z, Thuluvath P, Berzigotti A, Albillos A, Robinson J, Chan J, Hagerty D, Sanyal A. LBO-01-Multicenter, double-blind, placebo-controlled, randomized trial of emricasan in subjects with NASH cirrhosis and severe portal hypertension. Journal Of Hepatology 2019, 70: e127. DOI: 10.1016/s0618-8278(19)30225-7.Peer-Reviewed Original ResearchPrioritization of Therapeutic Targets and Trial Design in Cirrhotic Portal Hypertension
Abraldes JG, Trebicka J, Chalasani N, D’Amico G, Rockey DC, Shah VH, Bosch J, Garcia‐Tsao G. Prioritization of Therapeutic Targets and Trial Design in Cirrhotic Portal Hypertension. Hepatology 2019, 69: 1287-1299. PMID: 30318607, PMCID: PMC11090176, DOI: 10.1002/hep.30314.Peer-Reviewed Original ResearchConceptsNonalcoholic fatty liver diseasePortal pressurePortal hypertensionLiver diseaseCardiac output leadsCause of cirrhosisCirrhotic portal hypertensionChronic liver diseaseFatty liver diseasePortal venous inflowIntrahepatic vascular resistanceRisk of decompensationEarly clinical studiesCirrhosis decompensationSplanchnic vasodilationVascular resistancePharmacological therapyEtiological treatmentVenous inflowCirrhosis resultsSuch therapyClinical trialsBest therapyClinical studiesCirrhosisEmricasan (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
2018
LBO-001 A multicenter, randomized, double-blind, PLB-controlled trial of Galectin-3 inhibitor (GR-MD-02) in patients with NASH cirrhosis and portal hypertension
Chalasani N, Garcia-Tsao G, Goodman Z, Lawitz E, Abdelmalek M, Rinella M, Ryan M, Noureddin M, Jue C, Pyko M, Allgood A, Shlevin H, Horton R, Zomer E, Traber P, Loomba R, Tetri B, Sanyal A, Harrison S. LBO-001 A multicenter, randomized, double-blind, PLB-controlled trial of Galectin-3 inhibitor (GR-MD-02) in patients with NASH cirrhosis and portal hypertension. Journal Of Hepatology 2018, 68: s100-s101. DOI: 10.1016/s0168-8278(18)30420-3.Peer-Reviewed Original ResearchCirrhosis and Portal Hypertension: Staging and Prognosis
Garcia-Tsao G. Cirrhosis and Portal Hypertension: Staging and Prognosis. 2018, 1-13. DOI: 10.1007/978-3-319-72628-1_1.Peer-Reviewed Educational MaterialsSignificant portal hypertensionPortal hypertensionDecompensated stagePredominant pathophysiological mechanismPresence of varicesGastroesophageal varicesPrognostic significanceReversible diseasePathophysiological mechanismsDifferent therapiesHypertensionVaricesCirrhosisDecompensationPatientsTherapyDisease
2017
Management of Portal Hypertension
Garcia‐Tsao G, Abraldes J. Management of Portal Hypertension. 2017, 304-335. DOI: 10.1002/9781119251316.ch12.Peer-Reviewed Educational MaterialsComplications of cirrhosisPortal hypertensionVariceal hemorrhagePortal pressure gradientInferior vena cavaObjective of treatmentGastroesophageal varicesPortal pressurePathological increaseVena cavaPortal veinCommon causeCirrhosisHypertensionComplicationsHemorrhageMost studiesVaricesDecompensationCavaPrimary 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 conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatients