{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:32:30Z","timestamp":1790087550945,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":4536,"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":[[2003,4]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>In cirrhotic patients under pharmacologic treatment for portal hypertension, a reduction in hepatic venous pressure gradient (HVPG) of \u226520% of baseline or to \u226412 mm Hg markedly reduces the risk of variceal rebleeding. This study was aimed at evaluating whether these hemodynamic targets also prevent other complications of portal hypertension and improve long\u2013term survival. One hundred five cirrhotic patients included in prospective trials for the prevention of variceal rebleeding were studied. Seventy\u2013three of the patients had 2 separate HVPG measurements, at baseline and under pharmacologic therapy with propranolol \u00b1 isosorbide mononitrate. Patients were followed for up to 8 years. Survival and risk of developing portal hypertension\u2013related complications were compared between responders and nonresponders. Twenty\u2013eight patients showed a reduction of HVPG \u226520% of baseline or to \u226412 mm Hg (responders), and 45 patients were nonresponders. Nonresponders had a significantly greater risk of developing variceal rebleeding (<jats:italic toggle=\"yes\">P<\/jats:italic> = .013), ascites (<jats:italic toggle=\"yes\">P<\/jats:italic> = .025), spontaneous bacterial peritonitis (<jats:italic toggle=\"yes\">P<\/jats:italic> = .003), hepatorenal syndrome (<jats:italic toggle=\"yes\">P<\/jats:italic> = .026), and hepatic encephalopathy (<jats:italic toggle=\"yes\">P<\/jats:italic> = .024) than responders. Eight\u2013year cumulative probability of survival was significantly lower in nonresponders than in responders (52% vs. 95%, respectively, <jats:italic toggle=\"yes\">P<\/jats:italic> = .003). At multivariate analysis, being a nonresponder was independently associated with the risk of developing rebleeding, ascites, spontaneous bacterial peritonitis, and lower survival. In conclusion, in cirrhotic patients receiving pharmacologic treatment for prevention of variceal rebleeding, a decrease in HVPG \u226520% or to \u226412 mm Hg is associated with a marked reduction in the long\u2013term risk of developing complications of portal hypertension and with improved survival. (Hepatology 2003;37:902\u2013908.)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jhep.2003.50133","type":"journal-article","created":{"date-parts":[[2003,4,7]],"date-time":"2003-04-07T20:06:02Z","timestamp":1049745962000},"page":"902-908","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":449,"title":["Hemodynamic Response to Pharmacological Treatment of Portal Hypertension and Long\u2013Term Prognosis of Cirrhosis"],"prefix":"10.1097","volume":"37","author":[{"given":"Juan G.","family":"Abraldes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tarantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Turnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan 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