{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:31Z","timestamp":1786977871727,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Nonselective beta\u2010blockers are used as prophylaxis for variceal bleeding in patients with advanced chronic liver disease (ACLD). The acute hemodynamic response to intravenous propranolol (i.e., \u226510% reduction in hepatic venous pressure gradient [HVPG]) is linked to a decreased risk of variceal bleeding. In this study, we aimed to investigate the overall prognostic value of an acute response in compensated and decompensated ACLD. We analyzed the long\u2010term outcome of prospectively recruited patients with ACLD following a baseline HVPG measurement with an intraprocedural assessment of the acute hemodynamic response to propranolol. Overall, we included 98 patients with ACLD (mean\u2009\u00b1\u2009SD age, 56.4\u2009\u00b1\u200911.5\u2009years; 72.4% decompensated; 88.8% varices; mean\u2009\u00b1\u2009SD HVPG, 19.9\u2009\u00b1\u20094.4\u2009mm Hg) who were followed for a median of 9.6 (interquartile range, 6.5\u201318.2) months. Fifty\u2010seven patients (58.2%) demonstrated an acute hemodynamic response to propranolol that was associated with a decreased risk of variceal bleeding (at 12\u2009months, 3.6% vs. 15% in nonresponder; log\u2010rank,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.038) and hepatic decompensation (at 12\u2009months, 23% vs. 33% in nonresponder; log\u2010rank,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.096). On multivariate analysis, the acute response was an independent predictor of first\/further hepatic decompensation (adjusted hazards ratio, 0.31; 95% confidence interval [CI], 0.13\u20130.70;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.005). Importantly, there was a tendency toward a prolonged transplant\u2010free survival in acute responders compared to nonresponders (34.2; 95% CI, 29.2\u201339.2 vs. 25.2; 95% CI, 19.8\u201330.6 months; log\u2010rank,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.191).\n                    <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    : Patients with ACLD who achieve an acute hemodynamic response to intravenous propranolol experience a lower risk of variceal bleeding and nonbleeding hepatic decompensation events compared to nonresponders. An assessment of the acute hemodynamic response to intravenous propranolol provides important prognostic information in ACLD.\n                  <\/jats:p>","DOI":"10.1002\/hep4.2021","type":"journal-article","created":{"date-parts":[[2022,7,9]],"date-time":"2022-07-09T02:40:43Z","timestamp":1657334443000},"page":"2569-2580","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Acute hemodynamic response to propranolol predicts bleeding and nonbleeding decompensation in patients with cirrhosis"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-3372","authenticated-orcid":false,"given":"Benedikt S.","family":"Hofer","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9146","authenticated-orcid":false,"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-8518","authenticated-orcid":false,"given":"David J. M.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Paternostro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-8076","authenticated-orcid":false,"given":"Philipp","family":"Schwabl","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-5133","authenticated-orcid":false,"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-166X","authenticated-orcid":false,"given":"Georg","family":"Semmler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-6120","authenticated-orcid":false,"given":"Lukas","family":"Hartl","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2871-4147","authenticated-orcid":false,"given":"Mathias","family":"Jachs","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Datterl","sequence":"additional","affiliation":[{"name":"Pharmacy Department,Vienna General Hospital,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert F.","family":"Staettermayer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-0017","authenticated-orcid":false,"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"issue":"3","key":"hep42021-bib-0001-20241118","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.jhep.2017.10.020","article-title":"Clinical states of cirrhosis and competing 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