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Validation of Baveno VII criteria for clinically significant portal hypertension by two-dimensional shear wave elastography

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Abstract

Background

The Baveno VII consensus proposed criteria for the non-invasively diagnosis of clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease (cACLD). The performance of Baveno VII criteria for assessing CSPH by two-dimensional shear wave elastography (2D-SWE) had not been well validated. We aimed to validate the performance of Baveno VII criteria for rule-in and rule-out CSPH by 2D-SWE.

Method

This is an international multicenter study including cACLD patients from China and Croatia with paired liver stiffness measurement (LSM), spleen stiffness measurement (SSM) by 2D-SWE, and hepatic venous pressure gradient (HVPG) were included. CSPH was defined as HVPG ≥ 10 mmHg.

Result

A total of 146 patients with cACLD were enrolled, and finally 118 patients were included in the analysis. Among them, CSPH was documented in 79 (66.9%) patients. Applying the Baveno VII criteria for rule-out CSPH by 2D-SWE, [LSM ≤ 15 kPa and platelet count ≥ 150 × 109/L] OR SSM < 21 kPa, could exclude CSPH with sensitivity > 90% (93.5 or 98.7%) but negative predictive value < 90% (74.1 or 85.7%). Using the Baveno VII criteria for rule-in CSPH by 2D-SWE, LSM ≥ 25 kPa OR SSM ≥ 50 kPa, could diagnose CSPH with 100% specificity and 100% positive predictive values.

Conclusion

Baveno VII criteria by 2D-SWE showed a good diagnostic performance for ruling in but not for ruling out CSPH, which might become an emerging non-invasive elastography tool to select the patients who needed non-selective beta blocker therapy.

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Data availability

Data are available from the corresponding author upon reasonable request.

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Funding

National Natural Science Foundation of China (No. 82330060, 92059202, 92359304); Natural Science Foundation of Gansu (21JR1RA090); The Key Research and Development Program of Jiangsu Province (BE2023767); Youth Fund of the First Hospital of Lanzhou University (ldyyyn2021-62); The Fundamental Research Fund of Southeast University (3290002303A2); Research Personnel Cultivation Programme of Zhongda Hospital, Southeast University (CZXM-GSP-RC125); Changjiang Scholars Talent Cultivation Project of Zhongda Hospital of Southeast University (2023YJXYYRCPY03).

Author information

Author notes

  1. Ruiling He, Chuan Liu, Ivica Grgurevic, Ying Guo, Huixiong Xu and Jiacheng Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Ultrasound, Donggang Branch of the First Hospital of Lanzhou University, Lanzhou, China

    Ruiling He

  2. The First Clinical Medical College of Lanzhou University, Lanzhou, China

    Ruiling He & Xiaolong Qi

  3. Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, China

    Chuan Liu

  4. Department of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine and Faculty of Pharmacy and Biochemistry, University Hospital Dubrava, University of Zagreb, Zagreb, Croatia

    Ivica Grgurevic

  5. Department of Hepatology, The Third People’s Hospital of Taiyuan, Taiyuan, China

    Ying Guo, Yunfang Liu, XiaoYan Wang, Yongli Hua, Kun Wang & Jing Wen

  6. Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China

    Huixiong Xu & Yuli Zhu

  7. Department of Infectious Diseases, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China

    Jiacheng Liu & Jie Li

  8. Department of Ultrasound, The Third People’s Hospital of Taiyuan, Taiyuan, China

    Hongmei Shi & Meiqin Su

  9. 4-University Hospital Dubrava, Zagreb, Croatia

    Anita Madir

  10. Department of Gastroenterology and Hepatology, University Hospital Center Split, Split, Croatia

    Kristian Podrug

  11. Department of Infectious Disease, Zhongda Hospital, Medical School, Southeast University, Nanjing, China

    Qun Zhang

  12. Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University; State Key Laboratory of Digital Medical Engineering, Nanjing, China

    Chuan Liu

Authors
  1. Ruiling He
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  18. Jie Li
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Contributions

Study concept and design: RH, CL, IG, YG, HX, JL, and XQ. Supervision of the study: XQ and JL. Acquisition of data and technical support: YL, XYW, AM, KP, YZ, YH, KW, JW, MS, and QZ. Interpretation of data: RH and CL. Drafting of the manuscript: RH and JL. All authors approved this version for submission.

Corresponding authors

Correspondence to Jie Li or Xiaolong Qi.

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Conflict of interest

Ruiling He, Chuan Liu, Ivica Grgurevic, Ying Guo, Huixiong Xu, Jiacheng Liu, Yunfang Liu, XiaoYan Wang, Hongmei Shi, Anita Madir, Kristian Podrug, Yuli Zhu, Yongli Hua, Kun Wang, Jing Wen, Meiqin Su, Qun Zhang, Jie Li and Xiaolong Qi disclose no conflicts.

Ethical approval

The study was approved by the local Ethics Committee and was performed in accordance with the last revised version of the Helsinki Declaration.

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He, R., Liu, C., Grgurevic, I. et al. Validation of Baveno VII criteria for clinically significant portal hypertension by two-dimensional shear wave elastography. Hepatol Int 18, 1020–1028 (2024). https://doi.org/10.1007/s12072-024-10657-7

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