{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:01:27Z","timestamp":1791615687561,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>The enhanced liver fibrosis (ELF) score comprises serum markers of fibrogenesis and matrix remodelling and was developed to detect liver fibrosis, however, it may also be useful for the non\u2010invasive detection of portal hypertension (PHT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>ELF score and its single components (TIMP1\/PIIINP\/HA) were analysed in 201 patients with advanced chronic liver disease (ACLD; ie hepatic venous pressure gradient (HVPG) \u22656\u00a0mm Hg). Patients with pre\u2010\/post\u2010hepatic PHT, hepatocellular carcinoma beyond Milan criteria, and history of TIPS implantation or liver transplantation were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ELF and its single components correlated with HVPG in the overall cohort: ELF:<jats:italic> r<\/jats:italic>\u00a0=\u00a0.443, TIMP1: <jats:italic>r<\/jats:italic>\u00a0=\u00a0.368, PIIINP:<jats:italic>r<\/jats:italic>\u00a0=\u00a0.332, and HA:<jats:italic>r<\/jats:italic>\u00a0=\u00a0.419 (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The strength of the correlation between ELF and HVPG decreased in higher HVPG strata: 6\u20109\u00a0mm Hg:<jats:italic>r<\/jats:italic>\u00a0=\u00a0.569(<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004), 10\u201019\u00a0mm Hg:<jats:italic>r<\/jats:italic>\u00a0=\u00a0.304 (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001) and \u226520\u00a0mm Hg:<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.023(<jats:italic>P<\/jats:italic>\u00a0=\u00a0.853).<\/jats:p><jats:p>Area under the receiver operating characteristics (AUROC) of ELF score to detect clinically significant PHT (CSPH; HVPG\u00a0\u2265\u00a010\u00a0mm Hg) was 0.833. Importantly, HA alone yielded an AUROC of 0.828. Detection of CSPH in strictly compensated ACLD (cACLD) patients was less accurate: AUROC: 0.759 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). CSPH was ruled\u2010in by ELF\u00a0\u2265\u00a011.1 with a PPV of 98% (sensitivity: 61%\/specificity: 92%\/NPV:24%), but CSPH could not be ruled\u2010out.<\/jats:p><jats:p>ELF score had a low AUROC of 0.677 (0.60\u20100.75; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) for the diagnosis of high\u2010risk PHT (HRPH; HVPG\u00a0\u2265\u00a020mm Hg) and, thus, HRPH could not be ruled\u2010in by ELF. However, ELF\u00a0&lt;\u00a010.1 ruled\u2010out HRPH with a NPV of 95% (sensitivity: 97%\/specificity: 26%\/PPV: 39%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ELF score correlates with HVPG at values &lt;20\u00a0mm Hg. An ELF\u00a0\u2265\u00a011.1 identifies patients with a high probability of CSPH, while an ELF\u00a0&lt;\u00a010.1 may be used to rule\u2010out HRPH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14498","type":"journal-article","created":{"date-parts":[[2020,5,2]],"date-time":"2020-05-02T10:35:05Z","timestamp":1588415705000},"page":"1713-1724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Non\u2010invasive detection of portal hypertension by enhanced liver fibrosis score in patients with different aetiologies of advanced chronic liver disease"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9146","authenticated-orcid":false,"given":"Benedikt","family":"Simbrunner","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"},{"name":"Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases Vienna Austria"},{"name":"CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrig","family":"Marculescu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine 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 Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory 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 Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"},{"name":"Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases Vienna Austria"},{"name":"CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-4111","authenticated-orcid":false,"given":"Theresa","family":"Bucsics","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Stadlmann","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"},{"name":"Hospital Hietzing 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 Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-5769","authenticated-orcid":false,"given":"Rafael","family":"Paternostro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernst","family":"Eigenbauer","sequence":"additional","affiliation":[{"name":"IT\u2010Systems &amp; Communications Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-532X","authenticated-orcid":false,"given":"Matthias","family":"Pinter","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine III Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0737-4091","authenticated-orcid":false,"given":"Albert Friedrich","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal 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 Internal 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 Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory 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 Internal Medicine III Medical University of Vienna Vienna Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory Medical University of Vienna Vienna Austria"},{"name":"Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases Vienna Austria"},{"name":"CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60121-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.05.024"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.01.014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21984"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2009.01263.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.08.052"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.03.016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30842"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.01.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.09.013"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22517"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27825"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.203166"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12896"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149230"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13618"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29557"},{"key":"e_1_2_9_19_1","article-title":"Non\u2010invasive diagnostics for portal hypertension: a comprehensive review","author":"Mandorfer M","year":"2020","journal-title":"Semin Liver Dis"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-017-1262-3"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12623"},{"key":"e_1_2_9_24_1","first-page":"e58819","article-title":"Measurement of the hepatic venous pressure gradient and transjugular liver biopsy","author":"Reiberger T","year":"2020","journal-title":"J Visualized Exp"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12783"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04500.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03831.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2014.934910"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/37.1.30"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(86)90008-2"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03378.x"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21665"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.07.021"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28264"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-011-0517-4"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.08.002"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28824"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03701.x"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.001"},{"issue":"3","key":"e_1_2_9_40_1","first-page":"303","article-title":"The neo\u2010epitope specific PRO\u2010C3 ELISA measures true formation of type III collagen associated with liver and muscle parameters","volume":"5","author":"Nielsen MJ","year":"2013","journal-title":"Am J Transl Res"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.14498","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.14498","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.14498","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T04:46:35Z","timestamp":1693975595000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.14498"}},"subtitle":[],"editor":[{"given":"Virginia","family":"Hernandez\u2010Gea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/liv.14498"],"URL":"https:\/\/doi.org\/10.1111\/liv.14498","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,18]]},"assertion":[{"value":"2020-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}