2022
Ascites 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
2019
Prioritization 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
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
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
2014
Novel inflammatory biomarkers of portal pressure in compensated cirrhosis patients
Buck M, Garcia‐Tsao G, Groszmann RJ, Stalling C, Grace ND, Burroughs AK, Patch D, Matloff DS, Clopton P, Chojkier M. Novel inflammatory biomarkers of portal pressure in compensated cirrhosis patients. Hepatology 2014, 59: 1052-1059. PMID: 24115225, DOI: 10.1002/hep.26755.Peer-Reviewed Original ResearchConceptsHepatic vein pressure gradientGastroesophageal varicesCirrhosis patientsUnnecessary esophagogastroduodenoscopyPortal hypertensionInflammatory biomarkersMultivariate logistic regression analysisInflammatory serum biomarkersNovel inflammatory biomarkerSerum VCAM-1Logistic regression analysisAssociated morbidityCohort studyPortal pressureLiver injuryBlood testsClinical parametersInflammatory pathwaysSerum biomarkersClinical trialsVCAM-1IL-1RPatientsDiagnostic testsMmHg
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 survivalQuantitative histological‐hemodynamic correlations in cirrhosis
Sethasine S, Jain D, Groszmann RJ, Garcia‐Tsao G. Quantitative histological‐hemodynamic correlations in cirrhosis. Hepatology 2012, 55: 1146-1153. PMID: 22109744, PMCID: PMC3721182, DOI: 10.1002/hep.24805.Peer-Reviewed Original ResearchConceptsSignificant portal hypertensionPortal hypertensionFibrosis areaLiver biopsyCirrhotic nodulesNodule sizeHVPG measurementPortal pressureIndependent predictorsSeptal thicknessFibrous septaBiopsyPathophysiological implicationsCirrhosisHVPGPatientsSemiquantitative analysisNodulesOnly parameterHypertensionNumber of nodules
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 groupsPatientsManagement: Cirrhotic Portal Hypertension
Lim J, Garcia-Tsao G. Management: Cirrhotic Portal Hypertension. 2011, 165-181. DOI: 10.1007/978-1-4419-8327-5_11.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionVariceal hemorrhageAcute variceal hemorrhageCirrhotic portal hypertensionBetter risk stratificationNovel pharmacotherapeutic agentsGastroesophageal varicesPortal pressureRisk stratificationMain complicationsNoninvasive markerPharmacotherapeutic agentsIndividualized careHypertensionVaricesHemorrhageSignificant mortalityCirrhosisSignificant improvementProphylaxisComplicationsPatientsRecurrenceMortality
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
1997
The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices
Escorsell A, Ferayorni L, Bosch J, Garcia-Pagan J, Garcia-Tsao G, Grace N, Rodes J, Groszmann R. The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices. Gastroenterology 1997, 112: 2012-2016. PMID: 9178694, DOI: 10.1053/gast.1997.v112.pm9178694.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPortal pressure responseVenous pressure gradientCirrhotic patientsPortal pressurePortal hypertensionDevelopment of varicesSingle oral dosePressure responseSystemic hemodynamicsEsophageal varicesOral doseVaricesPatientsAbstractTextBeneficial effectsHypertensionTimololHgEarly stagesPressure gradientCirrhosisAIMSHemodynamicsDose
1995
Variceal Hemorrhage
Navarro V, Garcia-Tsao G. Variceal Hemorrhage. Critical Care Clinics 1995, 11: 391-414. PMID: 7788538, DOI: 10.1016/s0749-0704(18)30073-3.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsVariceal bleedingVariceal hemorrhageFirst variceal bleedingHigh recurrence ratePortal hypertensionBalloon tamponadePharmacologic therapyPortal pressureShunt surgeryActive hemorrhageRecurrence rateBlood flowTherapeutic avenuesHigh mortalityHemorrhageBleedingPreventionHypertensionTamponadeSclerotherapyComplicationsSurgeryRelative effectivenessTherapyMortality
1989
Long‐term hemodynamic effects of ketanserin, a 5‐hydroxytryptamine blocker, in portal hypertensive patients
Vorobioff J, Garcia‐Tsao G, Groszmann R, Aceves G, Picabea E, Villavicencio R, Hernandez‐Ortiz J. Long‐term hemodynamic effects of ketanserin, a 5‐hydroxytryptamine blocker, in portal hypertensive patients. Hepatology 1989, 9: 88-91. PMID: 2908873, DOI: 10.1002/hep.1840090114.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPortal hypertensive patientsVenous pressure gradientMean arterial pressureHypertensive patientsCardiac indexArterial pressureMean baseline hepatic venous pressure gradientBaseline hepatic venous pressure gradientLong-term hemodynamic effectsAcute hemodynamic studyChronic oral administrationHepatic venous pressurePoor liver functionAlcoholic cirrhosisPortal hypertensionReceptor blockersHemodynamic effectsPortal pressurePortosystemic encephalopathyChronic treatmentVenous pressureLiver functionMean doseHemodynamic studies
1987
Hemodynamic evaluation of isosorbide dinitrate in alcoholic cirrhosis Pharmacokinetic-hemodynamic interactions
Blei A, Garcia-Tsao G, Groszmann R, Kahrilas P, Ganger D, Morse S, Fung H. Hemodynamic evaluation of isosorbide dinitrate in alcoholic cirrhosis Pharmacokinetic-hemodynamic interactions. Gastroenterology 1987, 93: 576-583. PMID: 3301517, DOI: 10.1016/0016-5085(87)90921-8.Peer-Reviewed Original ResearchConceptsIsosorbide dinitratePortal pressureArterial pressureHemodynamic changesHemodynamic evaluationHepatic vein wedge pressureHepatic venous gradientSystemic hemodynamic changesMean arterial pressureEffects of placeboValues 4 hStable cirrhoticsAlcoholic cirrhosisCardiac indexPortal hypertensionWedge pressureHemodynamic benefitsVenous gradientVasoactive metabolitesPharmacologic agentsIndividual patientsBaseline valuesExperimental animalsDinitratePatientsPortal hemodynamics during nitroglycerin administration in cirrhotic patients
Garcia‐Tsao G, Groszmann R. Portal hemodynamics during nitroglycerin administration in cirrhotic patients. Hepatology 1987, 7: 805-809. PMID: 3115881, DOI: 10.1002/hep.1840070502.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientEffects of nitroglycerinMean arterial pressurePortal pressureArterial pressureNitroglycerin administrationBlood flowExperimental animalsAzygos blood flowPortal venous hemodynamicsPortal hypertensive patientsPortal blood flowVenous dilatorHypertensive patientsAlcoholic cirrhosisArterial vasodilatorCirrhotic patientsBlood pressurePortal hemodynamicsSublingual nitroglycerinVenous hemodynamicsHemodynamic responsePeak changesHeart rate
1986
Short‐term effects of propranolol on portal venous pressure
Garcia‐Tsao G, Grace N, Groszmann R, Conn H, Bermann M, Patrick M, Morse S, Alberts J. Short‐term effects of propranolol on portal venous pressure. Hepatology 1986, 6: 101-106. PMID: 3943775, DOI: 10.1002/hep.1840060119.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientPropranolol plasma levelsHeart rateVenous pressurePlasma levelsMean baseline hepatic venous pressure gradientBaseline hepatic venous pressure gradientHepatic venous pressureBlood pressure responsePortal venous pressureEffect of propranololBaseline laboratoryAlcoholic cirrhosisPortal hypertensionPortal pressureLaboratory parametersLiver diseasePropranolol administrationAdditional dosesHemodynamic parametersOral administrationShort-term effectsPropranololPatients
1985
Portal pressure, presence of gastroesophageal varices and variceal bleeding
Garcia‐Tsao G, Groszmann R, Fisher R, Conn H, Atterbury C, Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology 1985, 5: 419-424. PMID: 3873388, DOI: 10.1002/hep.1840050313.Peer-Reviewed Original ResearchConceptsHepatic vein pressure gradientSmall varicesCirrhotic patientsPortal pressureLarge varicesSize of varicesHepatic vein catheterizationOccurrence of hemorrhagePortal pressure measurementsAlcoholic cirrhosisGastroesophageal varicesVariceal bleedingEsophagogastric varicesVariceal sizeVein catheterizationVaricesPatientsStandardized measurementsHgPressure measurementsCirrhosisBleedingCatheterizationHemorrhageEndoscopy