{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:37:41Z","timestamp":1768703861159,"version":"3.49.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5601,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2000,5]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Noninvasive measurements of variceal pressure adequately reflect the hemodynamic effects of propranolol on portal hypertension. However, the prognostic value of variceal pressure responses during continued propranolol therapy has not been evaluated, and it is unclear whether this may substitute invasive measurements of portal pressure response. Fifty-five portal hypertensive patients with cirrhosis were studied before and at 4 months of continued propranolol therapy. Variceal pressure was measured using an endoscopic pressure gauge. Portal pressure was evaluated as the hepatic venous pressure gradient (HVPG). Over a 28 \u00b1 11 month follow-up, 16 patients experienced variceal bleeding. Baseline characteristics were similar in bleeders and nonbleeders. At 4 months, reduction in variceal pressure was less marked in bleeders than in nonbleeders (5% \u00b1 20% vs. \u221215% \u00b1 24%; <jats:italic toggle=\"yes\">P<\/jats:italic> = .03). A fall in variceal pressure 20% or greater of baseline was an independent predictor of absence of variceal bleeding; which occurred in 5% of patients with a 20% or greater fall in variceal pressure versus 42% of patients with less than a 20% reduction (<jats:italic toggle=\"yes\">P<\/jats:italic> = .004). The HVPG response had similar independent prognostic value (decrease \u226520%: 6% bleeding; decrease &lt;20%: 45% bleeding; <jats:italic toggle=\"yes\">P<\/jats:italic> = .004) but identified different patients. Achieving a 20% decrease in either variceal pressure or HVPG was highly sensitive (85%) and specific (93%) identifying patients not bleeding on follow-up. Endoscopic measurements of variceal pressure response to continued pharmacotherapy provide useful prognostic information on the risk of variceal bleeding. As with HVPG response, a fall in variceal pressure of 20% or greater is associated with a very low risk of variceal bleeding. The combination of both parameters allows almost optimal prognostication.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/he.2000.6779","type":"journal-article","created":{"date-parts":[[2004,3,19]],"date-time":"2004-03-19T18:32:14Z","timestamp":1079721134000},"page":"1061-1067","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":134,"title":["Predictive value of the variceal pressure response to continued pharmacological therapy in patients with cirrhosis and portal hypertension"],"prefix":"10.1097","volume":"31","author":[{"given":"\u00c0ngels","family":"Escorsell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Maria","family":"Bordas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Casta\u00f1eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Llach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan Carles","family":"Garc\u00eda-Pag\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Rod\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1053\/he.2000.6779-BIB1","first-page":"671","volume-title":"Oxford Textbook of Clinical Hepatology","author":"Bosch","year":"1999","unstructured":". Clinical manifestations and management of bleeding episodes in cirrhotics. In: , , , eds. Oxford Textbook of Clinical Hepatology. 2nd ed. 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Sore Points: a review of the points where there was disagreement at Baveno I, and an attempt to reach consensus. In: eds. Portal Hypertension II: Proceedings of the Second International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. 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Baveno II consensus statements: drug therapy for portal hypertension. In: eds. Portal Hypertension II: Proceedings of the Second International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. 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Imaging techniques and hemodynamic measurements in portal hypertension. In: eds. Portal Hypertension II: Proceedings of the Second International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies. 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