{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T22:38:14Z","timestamp":1788820694341,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Indocyanine green (ICG) clearance, determined by venous sampling, has shown promising results in the diagnosis of clinically significant portal hypertension (CSPH) in compensated advanced chronic liver disease (cACLD) and prognostication in decompensated ACLD (decompensated cirrhosis). Data on ICG clearance measurement by pulse dye densitometry (PDD) via finger clip are comparatively scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the diagnostic (CSPH) and prognostic utility of ICG clearance throughout ACLD stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ACLD (liver stiffness \u2265\u200910\u2009kPa) patients undergoing same\u2010day hepatic venous pressure gradient (HVPG) measurement and ICG clearance assessment via PDD in 2017\u20132022 were recruited from the prospective Vienna Cirrhosis Study (VICIS, NCT03267615).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and sixty\u2010one ACLD patients (cACLD:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009115, decompensated cirrhosis:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009146) were included. Among cACLD patients (CSPH: 62.4%), ICG retention 15\u2009min (ICG\u2010R15) correlated moderately with HVPG (Spearman's rho:0.458;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and yielded a suboptimal diagnostic accuracy for CSPH (AUROC: 0.687 [95% CI: 0.585\u20130.789]). ICG\u2010R15 showed a strong correlation with the model for end\u2010stage liver disease score (rho: 0.701;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and correlated with biomarkers of endothelial dysfunction (von Willebrand factor), systemic inflammation (C\u2010reactive protein, procalcitonin, interleukin 6) and extracellular matrix remodelling (enhanced liver fibrosis test). In decompensated cirrhosis, ICG\u2010R15 additionally correlated with mean arterial pressure, serum sodium and renin levels. ICG\u2010R15 predicted decompensation (subdistribution hazard ratio [SHR]: 1.042 [95% CI: 1.008\u20131.077] per %;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) in cACLD and independently predicted ACLF\/liver\u2010related mortality in decompensated cirrhosis (adjusted SHR: 1.062 [95% CI: 1.025\u20131.100] per %;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICG\u2010R15 by PDD correlates with portal hypertension and systemic inflammation\/circulatory dysfunction as key disease\u2010driving mechanisms in ACLD. While showing insufficient discrimination for CSPH, ICG\u2010R15 independently predicted ACLF\/liver\u2010related mortality in decompensated cirrhosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70447","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T07:15:28Z","timestamp":1762413328000},"page":"874-884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Indocyanine Green Clearance Correlates With Biomarkers Reflecting Key Disease\u2010Driving Mechanisms in Advanced Chronic Liver Disease and Predicts Acute\u2010on\u2010Chronic Liver Failure and Death"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2871-4147","authenticated-orcid":false,"given":"Mathias","family":"Jachs","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine III Medical University of Vienna  Vienna 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