Open AccessChanges in transient elastography in early cirrhotic patients after receiving nonselective B‐blocker for primary variceal bleeding prophylaxis: Three‐month follow up
Author(s) -
Piyachaturawat Panida,
Siramolpiwat Sith,
Sonsiri Kanokwan,
Tangkijvanich Pisit,
Treeprasertsuk Sombat
Publication year - 2018
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12063
Subject(s) - transient elastography , medicine , esophagogastroduodenoscopy , esophageal varices , gastroenterology , prospective cohort study , carvedilol , portal hypertension , varices , heart rate , heart failure , cirrhosis , endoscopy , blood pressure , liver fibrosis
Background and Aim A nonselective B‐blocker (NSBB) is recommended for primary prophylaxis of variceal bleeding. The impact of treatment with NSBB on modulating transient elastography (TE) has not been reported. The aim of the study is to investigate the effect of NSBB treatment on TE in early cirrhotic patients. Methods In this prospective study, we enrolled all early cirrhotic patients who underwent esophagogastroduodenoscopy (EGD) and showed small esophageal varices (EV) at our institute for a period of 1 year. The TE and heart rate (HR) of all participants were measured before and 3 months after receiving NSBB. Results Thirty‐nine patients receiving propanolol for 3 months were analyzed. There were 16 patients in the HR responder group (41%) and 23 patients in the HR nonresponder group (59%). The reduction of TE was preferably found in the HR responder group compared with the HR nonresponder group, in which mean changes in TE were −5.6 and −0.7 kPa, respectively ( P = 0.23). In addition, we categorized the patients using their TE responses. Twenty‐five patients (64.1%) showed reduced TE during the follow‐up period, in which the mean TE value change was −2.94 kPa. Using correlation analysis, TE and HR responses were insignificantly correlated ( r = 0.23, P = 0.15). Conclusion The NSBB administered for 3 months mainly improved TE value in early cirrhotic patients even though the changes of HR and TE did not correlate. Further study is needed to confirm whether the monitoring of TE change may be a better predictor for pharmacological response than the HR response.