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Lunova M, Frankova S, Gottfriedova H, et al. Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis. Physiol Res. 2021;70(4):563-577doi: 10.33549/physiolres.934626.
Lunova, M., Frankova, S., Gottfriedova, H., Senkerikova, R., Neroldova, M., Kovac, J., Kieslichova, E., Lanska, V., Sticova, E., Spicak, J., Jirsa, M., & Sperl, J. (2021). Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis. Physiological research, 70(4), 563-577. https://doi.org/10.33549/physiolres.934626
Lunova, M, et al. "Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis." Physiological research vol. 70,4 (2021): 563-577. doi: https://doi.org/10.33549/physiolres.934626
Lunova M, Frankova S, Gottfriedova H, Senkerikova R, Neroldova M, Kovac J, Kieslichova E, Lanska V, Sticova E, Spicak J, Jirsa M, Sperl J. Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis. Physiol Res. 2021 Aug 31;70(4):563-577. doi: 10.33549/physiolres.934626. Epub 2021 Jun 01. PMID: 34062072.
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Physiol Res. 2021 Aug 31;70(4):563-577. doi: 10.33549/physiolres.934626. Epub 2021 Jun 01.

Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis.

Physiological research

M Lunova, S Frankova, H Gottfriedova, R Senkerikova, M Neroldova, J Kovac, E Kieslichova, V Lanska, E Sticova, J Spicak, M Jirsa, J Sperl

Affiliations

  1. Department of Hepatogastroenterology, Transplant Centre; Institute for Clinical and Experimental Medicine, Prague, Czech Republic. [email protected].

PMID: 34062072 DOI: 10.33549/physiolres.934626

Abstract

Liver stiffness (LS) is a novel non-invasive parameter widely used in clinical hepatology. LS correlates with liver fibrosis stage in non-cirrhotic patients. In cirrhotic patients it also shows good correlation with Hepatic Venous Pressure Gradient (HVPG). Our aim was to assess the contribution of liver fibrosis and portal hypertension to LS in patients with advanced liver cirrhosis. Eighty-one liver transplant candidates with liver cirrhosis of various aetiologies underwent direct HVPG and LS measurement by 2D shear-wave elastography (Aixplorer Multiwave, Supersonic Imagine, France). Liver collagen content was assessed in the explanted liver as collagen proportionate area (CPA) and hydroxyproline content (HP). The studied cohort included predominantly patients with Child-Pugh class B and C (63/81, 77.8%), minority of patients were Child-Pugh A (18/81, 22.2%). LS showed the best correlation with HVPG (r=0.719, p< 0.001), correlation of LS with CPA (r=0.441, p< 0.001) and HP/Amino Acids (r=0.414, p< 0.001) was weaker. Both variables expressing liver collagen content showed good correlation with each other (r=0.574, p<0.001). Multiple linear regression identified the strongest association between LS and HVPG (p < 0.0001) and weaker association of LS with CPA (p = 0.01883). Stepwise modelling showed minimal increase in r2 after addition of CPA to HVPG (0.5073 vs. 0.5513). The derived formula expressing LS value formation is: LS = 2.48 + (1.29 x HVPG) + (0.26 x CPA). We conclude that LS is determined predominantly by HVPG in patients with advanced liver cirrhosis whereas contribution of liver collagen content is relatively low.

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