Noninvasive Way to Predict Hemodynamic Response to Beta-Blockers for Preventing Variceal Bleeding in Cirrhosis

Using beta-blocker therapy to prevent bleeding in those with high-risk esophageal varices is effective and halves the overall risk. However, efficacy varies with the therapy's ability to reduce the hepatic venous pressure gradient (HVPG) — an estimation of portal pressure. HVPG measurements are expensive and invasive.

This prospective cohort study evaluated the accuracy of noninvasive measurements of liver stiffness (LS) and spleen stiffness (SS), compared with HVPG measurements, in predicting response to beta-blocker (carvedilol) prophylaxis. Paired measurements were obtained and a prediction model for hemodynamic response was derived using 106 cirrhotic patients with HVPG >12 mm Hg at baseline; high-risk esophageal varices were defined as …