MmHgGradientVaricealUnderwentAscitesClinicallyCirrhosis and portal hypertensionCirrhotic patientsOutcomesHepatocellular carcinomaTransjugularVenousCSPHComplicationsIntrahepaticDecompensationVeinVaricesDiagnosisPrognosticEndoscopyMeasurementsMELDMarkersSevereConcentrationsRespondersAssessmentMethodsHepatologySplanchnicCollateral circulationMortalitySignificantFibrosisLiver failureDiseasePlasmaEtiologyStratificationOutcomeMarkedlyAsymptomaticAims
MmHg4
- Portal venous pressure is the blood pressure in the hepatic portal vein, and is normally between 5-10 mmHg. (wikipedia.org)
- An HVPG of ≥5 mmHg defines portal hypertension, and if the measurement exceeds 10 mmHg it is called clinically significant portal hypertension. (wikipedia.org)
- Portal hypertension is defined by a hepatic venous pressure gradient (HVPG) greater than 5 mmHg. (gastrotraining.com)
- According to Dr. Hernández-Gea, there are only two scores that will help guide physicians on determining which patients should receive pre-emptive TIPS: those with HVPG greater than 20 mmHG or those with clinical criteria such as Child-Pugh C scores less than 14 points and Child B plus active bleeding at endoscopy. (cookmedical.eu)
Gradient10
- Here, we present a protocol for measurement of hepatic venous pressure gradient (HVPG),the gold standard to diagnose clinically significant portal hypertension. (jove.com)
- Here we provide a detailed protocol describing the clinical procedure of hepatic venous pressure gradient (HVPG) measurement in patients with advanced chronic liver disease followed by an instruction for transjugular biopsy. (jove.com)
- Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard to estimate portal venous pressure in patient with cirrhosis, i.e. assessing the severity of sinusoidal portal hypertension 4 . (jove.com)
- Importantly, hepatic venous pressure gradient (HVPG) will be measured in all patients that ensuring a comprehensive and reliable characterization of the severity of portal hypertension at the time of hormone level assessment. (meduniwien.ac.at)
- citation needed] HVPG is a clinical measurement of the pressure gradient between the WHVP and the free hepatic venous pressures (FHPV), and thus is an estimate of the pressure gradient between the portal vein and the inferior vena cava. (wikipedia.org)
- As the most accurate method for the assessment of PH is an invasive direct measurement of hepatic venous pressure gradient (HVPG), the search for non-invasive methods to diagnose these conditions is actively ongoing. (bvsalud.org)
- Background/Aims: The hepatic venous pressure gradient (HVPG) reflects portal hypertension, but its measurement is invasive. (elsevierpure.com)
- Hepatic venous pressure gradient (HVPG) is associated with a risk of liver events in patients with chronic hepatitis C. Antiviral therapies that lead to a sustained virologic response (SVR) reduce portal pressure and prevent liver disease progression. (hcv-trials.com)
- Non-invasive candidate protein signature predicts hepatic venous pressure gradient reduction in cirrhotic patients after sustained virologic response. (novartis.com)
- A reduction in hepatic venous pressure gradient (HVPG) is the most accurate marker for assessing the severity of portal hypertension and the effectiveness of intervention treatments. (novartis.com)
Variceal10
- Common signs and symptoms may stem from decreased hepatic synthetic function (eg, coagulopathy), portal hypertension (eg, variceal bleeding), or decreased detoxification capabilities of the liver (eg, hepatic encephalopathy). (medscape.com)
- The aim of this study was to assess the role of non-invasive scores in predicting the presence of EV in patients with liver cirrhosis, and to determine the value of these scores in predicting the outcome of patients with cirrhosis presenting with acute variceal bleeding. (mdpi.com)
- Clinically, measurement of HVPG is indicated (i) to establish the diagnosis of sinusoidal portal hypertension, (ii) to identify patients at risk for hepatic decompensation by diagnosing CSPH (HVPG ≥10 mm Hg), (iii) to guide pharmacological therapy in primary or secondary prophylaxis of variceal bleeding, and (iv) to assess the risk of hepatic failure after partial hepatectomy 2 , 4 . (jove.com)
- HVPG is used as an established surrogate marker for improvement and/or worsening of liver fibrosis/function, since a decrease in HVPG translates into a clinically meaningful benefit 5 , whereas higher HVPG values are associated with an increased variceal bleeding risk 6 . (jove.com)
- Transjugular intrahepatic portosystemic shunt (TIPS) offers an effective treatment for patients with complications of portal hypertension, specifically prevention of variceal rebleeding and recurrent or refractory ascites. (emjreviews.com)
- 1 These sequelae, variceal bleeding and refractory ascites, are associated with poor patient prognosis. (emjreviews.com)
- During the follow-up period, 19 patients developed liver decompensation (ascites, variceal bleeding, or encephalopathy). (hcv-trials.com)
- Malnutrition increases the risk of adverse outcomes in patients with cirrhosis and acute variceal bleeding (AVB) and oral nutrition should be started as soon as possible. (thesecretsofmedicine.com)
- Hepatologist Dr. Hernández-Gea, an expert on portal hypertension, discussed the role of TIPS in patients with variceal bleeding. (cookmedical.eu)
- Dr. Hernandez-Gea explained that 20% of patients with variceal bleeding will respond to the treatment but are at risk of early re-bleeding. (cookmedical.eu)
Underwent7
- Methods: Between January 2008 and March 2017, 556 patients who underwent HVPG and TE were consecutively enrolled. (elsevierpure.com)
- Data from 100 patients with hepatitis C and compensated cirrhosis who underwent HVPG measurement 3 months or less before (baseline) and 24 weeks after therapy with pegylated interferon alfa-2a and ribavirin at 4 hospitals in Spain, from 2001 through 2009. (hcv-trials.com)
- Patients underwent paired HVPG (pretreatment and after SVR), liver stiffness (LSM), and enhanced liver fibrosis scores (ELF) measurements, as well as proteomics-based profiling on serum samples using SomaScan® at baseline (BL) and after SVR (EOS). (novartis.com)
- Methods A total of 115 patients with BPT (n = 72) or MPT (n = 43) who underwent ultrasound (US), SE, and CEUS were enrolled. (thieme.de)
- Patients with liver cirrhosis referred for HVPG measurements underwent hepatic Doppler ultrasound, LS measurement, and D-CEUS with a second-generation contrast agent. (thieme.de)
- Between 2000 and 2015, 2165 patients underwent liver transplant at our center. (ectrx.org)
- The Institutional Pathology Department database was searched to identify cases of VOD occurring in patients who underwent liver transplant between 2000 and 2015. (ectrx.org)
Ascites4
- Paracentesis is essential in determining whether ascites is caused by portal hypertension or by another process. (medscape.com)
- Patients with cirrhosis are at risk for developing complications mostly related to portal hypertension (PHT), such as ascites or bleeding from gastric or esophageal varices 1 , 2 , 3 . (jove.com)
- Raised portal venous pressure is termed portal hypertension, and has numerous sequelae such as ascites and hepatic encephalopathy. (wikipedia.org)
- Evidently, the diagnosis is straightforward when a patient has already developed clinical manifestations of portal hypertension such as ascites, varices and hypersplenism. (e-cmh.org)
Clinically6
- The difference between FHVP and WHVP is referred to as HVPG, with values ≥10 mm Hg indicating clinically significant portal hypertension (CSPH). (jove.com)
- WHVP in fact slightly underestimates portal pressure due to sinusoidal equilibration in patients without cirrhosis, but the difference between the two is clinically insignificant. (wikipedia.org)
- To analyze the association between the liver uptake of gadoxetic acid (Gd-EOB-DTPA) in the hepatobiliary phase (HBP) in cirrhotic patients and the presence of clinically significant portal hypertension (CSPH), and how these features impact on HCC detection in the HBP. (radioloncol.com)
- BACKGROUND: Degree of portal hypertension (PH) is the most important prognostic factor for the decompensation of liver cirrhosis and death, therefore adequate care for patients with liver cirrhosis requires timely detection and evaluation of the presence of clinically significant PH (CSPH) and severe PH (SPH). (bvsalud.org)
- But in view of the wide use of simvastatin, clinically apparent liver injury is exceeding rare and is estimated to occur in 1 per 100,000 patient years of exposure. (nih.gov)
- The Sequential Application of Baveno VII Criteria and VITRO Score Improves Diagnosis of Clinically Significant Portal Hypertension. (liver.at)
Cirrhosis and portal hypertension2
- La Mura et al correlated plasma levels of von Willebrand factor (vWF) with prognosis for patients with cirrhosis and portal hypertension. (medicalalgorithms.com)
- Characterization of a prothrombotic phenotype using thrombin generation and thrombin activity in cirrhosis and portal hypertension. (liver.at)
Cirrhotic patients2
- Post-hoc analysis of a prospective cohort of 62 cirrhotic patients with newly US-detected nodule between 1-2 cm (study group). (radioloncol.com)
- This study aimed to evaluate the prognostic potential of blood-based proteomic biomarkers in predicting HVPG response amongst cirrhotic patients with portal hypertension due to Hepatitis C virus (HCV) and had achieved sustained virologic response (SVR).The study comprised 59 patients from two cohorts. (novartis.com)
Outcomes4
- However, the effect of viral suppression on long-term clinical outcomes in these patients particularly with clinical significant portal hypertension (CSPH) remains to be established. (hcv-trials.com)
- Here, we reviewed our experience to evaluate clinical presentation, treat-ment, and the long-term outcomes of these patients. (ectrx.org)
- Furthermore, long-term outcomes of these patients have so far not been evaluated. (ectrx.org)
- We aim to describe the patient profile, clinical severity and outcomes of the patients who present with UGIB to the ED of tertiary referral hospitals in Tanzania. (researchsquare.com)
Hepatocellular carcinoma3
- This study assessed the effects of HVPG and SVR on the risk of liver decompensation, hepatocellular carcinoma, and/or death in patients with hepatitis C-related cirrhosis. (hcv-trials.com)
- In particular, their role in the selection of patients for hepatocellular carcinoma surveillance and varices screening is highlighted. (e-cmh.org)
- Three patients died due to veno-occlusive disease (n = 2) or due to hepatocellular carcinoma recurrence (n = 1). (ectrx.org)
Transjugular4
- During angiography, a catheter is placed selectively via either the transjugular or transfemoral route into the hepatic vein to measure portal pressure. (medscape.com)
- Two patients were treated by increasing immunosup-pression and with interventional pro-cedures (pleurodesis and transjugular intrahepatic portosystemic shunt, respectively), and 2 had successful retransplants. (ectrx.org)
- This is the second of three blogs focused on the benefits of early transjugular intrahepatic portosystemic shunt (TIPS) procedures for patients suffering from portal hypertension. (cookmedical.eu)
- Cook Medical sponsored a webcast discussion between specialists in interventional radiology and hepatology on the need for early transjugular intrahepatic portosystemic shunt (TIPS) procedures in patients who suffer from portal hypertension. (cookmedical.eu)
Venous5
- An elevated arterial or free venous serum ammonia level is the classic laboratory abnormality reported in patients with hepatic encephalopathy. (medscape.com)
- WHVP is used to estimate the portal venous pressure by reflecting not the actual hepatic portal vein pressure but the hepatic sinusoidal pressure. (wikipedia.org)
- In patients with cirrhotic livers intersinusoidal communication is disrupted such that sinusoidal pressure equilibrium cannot be maintained, and so WHVP becomes a far more accurate measure of portal venous pressure. (wikipedia.org)
- Hepatic portal venous gas (HPVG) is a rare clinical finding, often caused by a severe underlying disease. (thieme.de)
- Normal uncorrected portal pressure is 5-10mm Hg and is influenced by the intra-abdominal pressure and central venous filling pressure. (gastrotraining.com)
CSPH10
- An HVPG of ≥6 mm Hg to 9 mm Hg indicates elevated portal pressure ('subclinical portal hypertension'), while an HVPG ≥10 mm Hg defines CSPH. (jove.com)
- Nineteen patients (30.6%) did not have CSPH. (radioloncol.com)
- All indices were significantly higher in the control group, indicating a more intense HBP liver signal intensity compared to patients with cirrhosis, even if the comparison was restricted to patients with no CSPH. (radioloncol.com)
- Liver uptake of Gd-EOB-DTPA at the HBP is decreased in cirrhosis even if the liver function is minimally impaired and it falls down significantly in patients with CSPH compromising the recognition of hypointense lesions. (radioloncol.com)
- This fact may represent a limitation for the detection of small HCC in patients with cirrhosis and CSPH. (radioloncol.com)
- Three parameters showed statistically significant differences between patient groups with CSPH, but only d retro showed significant results in SPH analysis. (bvsalud.org)
- However, it is not clear to what extent the progression of hepatitis C is modified once patients develop cirrhosis with severe portal hypertension (CSPH) (HVPG ≥ 10 mm Hg). (hcv-trials.com)
- Among the 74 patients with CSPH at baseline, 35% achieved an SVR. (hcv-trials.com)
- In conclusion, patients with CSPH, regardless of an SVR to therapy for hepatitis C, remain at risk for liver decompensation within the first 5 years after treatment, and should be monitored closely. (hcv-trials.com)
- All patients developing liver decompensation during follow-up evaluation had CSPH at baseline. (hcv-trials.com)
Complications7
- In patients with Marfan's syndrome , chronic management with propranolol may reduce the rate of aortic dilation and associated complications including aortic dissection and regurgitation. (pharmacology2000.com)
- This review focusses on the optimisation of the use of a covered TIPS endoprosthesis in patients with portal hypertension-related complications, with consideration of evolving practices, patient selection, and multidisciplinary co-operation. (emjreviews.com)
- 2 Elevated portal pressure increases cardiac output and reduces systemic vascular resistance, increasing blood flow and leading to serious complications. (emjreviews.com)
- Treatment of portal hypertension focusses on preventing or managing complications and, at first-line, is dependent largely on pharmacological approaches, which include non-selective beta-blockers (NSBB). (emjreviews.com)
- Despite the increasing prevalence of NAFLD and NASH cirrhosis, there are still no Food and Drug Administration (FDA)-approved pharmacotherapies which halt progression in the spectrum of the disease and reduce liver-related complications in patients with NAFLD. (e-cmh.org)
- The degree of portal hypertension could be a relevant parameter for defining " a non return" point f or developing clinical complications of portal hypertension despite achieving SVR. (hcv-trials.com)
- As the disease progresses, various complications of portal hypertension may develop. (e-cmh.org)
Intrahepatic1
- Portal hypertension can have prehepatic, intrahepatic, or posthepatic causes. (medscape.com)
Decompensation1
- The baseline level of HVPG, but not SVR, was associated independently with the risk of liver decompensation. (hcv-trials.com)
Vein5
- HCC carries a high risk of invasion of the portal vein. (gabasignaling.com)
- Comparison of peripheral and hepatic vein blood compartments of patients with cirrhosis did not reveal differentially abundant taxa. (bvsalud.org)
- Portal Vein Stenting. (mallareddynarayana.com)
- Discuss portal vein anatomy? (gastrotraining.com)
- All patients with AVB should undergo abdominal imaging, preferably contrast-enhanced cross-sectional imaging (CT or MRI) to exclude splanchnic vein thrombosis, HCC and to map portosystemic collaterals in order to guide treatment. (thesecretsofmedicine.com)
Varices2
- About 65.1% of the patients had severe anemia but only 60 (48.8%) received blood transfusion in the ED. Amongst those with h/o esophageal varices 7(41.2%) did not receive octreotide. (researchsquare.com)
- Rather than being due to alcoholic liver disease as in HIC's, varices in sub-Saharan Africa result from Schistosoma-related portal hypertension (7,11,12). (researchsquare.com)
Diagnosis3
- In 41 patients (66.1%) the final diagnosis was HCC. (radioloncol.com)
- CONCLUSION: The parameters of endogenously induced displacements and strain of the liver correlated with HVPG and might be used for non-invasive diagnosis of PH. (bvsalud.org)
- The Department of Radiology is key in making sure patients receive the correct diagnosis and successful treatments by giving important data to other medical specialities. (mallareddynarayana.com)
Prognostic1
- Prognostic assessment in patients with hepatic encephalopathy. (hepa-merz.com)
Endoscopy3
- Intubation is recommended before endoscopy in patients with altered consciousness and those actively vomiting blood. (thesecretsofmedicine.com)
- Following haemodynamic resuscitation, patients with suspected AVB should undergo upper endoscopy within 12 h of presentation. (thesecretsofmedicine.com)
- If the patient is unstable, endoscopy should be performed as soon as safely possible. (thesecretsofmedicine.com)
Measurements1
- Albilllos A, Garcia-Tsao G. Classification of cirrhosis: the clinical use of HVPG measurements. (hepa-merz.com)
MELD1
- Plasma vWF concentrations and the MELD score can identify a patient who may benefit from more aggressive management. (medicalalgorithms.com)
Markers1
- This study aimed to explore circulating bacterial DNA signatures, inflammatory cytokines, and gut permeability markers in different blood compartments (peripheral and hepatic veins) of patients with cirrhosis and PH. (bvsalud.org)
Severe1
- The symptoms of hepatic encephalopathy may range from mild to severe and may be observed in as many as 70% of patients with cirrhosis. (medscape.com)
Concentrations1
- This, in turn, can lead to decreased detoxification of ammonia in the liver as a result of (a) loss of vital hepatic parenchyma: synthesis of urea and glutamine is reduced and (b) collateral circulation due to portal hypertension leads to increased concentrations of ammonia in the blood. (hepa-merz.com)
Responders3
- Machine learning with feature selection (Caret, Random Forest and RPART) methods were performed to determine the proteins capable of classifying HVPG responders. (novartis.com)
- Twelve proteins accurately distinguished responders from non-responders, with an AUROC of .86, sensitivity of 83%, specificity of 83%, accuracy of 83%, PPV of 83%, and NPV of 83%.A combined non-invasive soluble protein signature was identified, capable of accurately predicting HVPG response in HCV liver cirrhosis patients after achieving SVR. (novartis.com)
- The primary end point was the proportion of week 12 responders (patients with moderate or substantial improvement in IBS symptoms) on the 7-point Likert Global Improvement Scale (GIS). (researchgate.net)
Assessment1
- In general, the tests have high negative predictive value in excluding advanced fibrosis and cirrhosis and have been recommended by the European Association for the Study of the Liver as initial assessment in patients with various liver diseases. (e-cmh.org)
Methods2
- Patients and methods. (radioloncol.com)
- METHODS: Of 36 patients with liver cirrhosis and measured HVPG were included in the case-control study. (bvsalud.org)
Hepatology1
- Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological disorders seen most often in patients. (researchgate.net)
Splanchnic1
- NSBB reduce cardiac output and induce splanchnic vasoconstriction, efficiently treating portal hypertension. (emjreviews.com)
Collateral circulation2
- When the portal circulation is obstructed, whether it is within or outside the liver, a remarkable collateral circulation develops to carry portal blood into the systemic circulation veins. (gastrotraining.com)
- Collaterals usually imply PH although occasionally if the collateral circulation is very extensive portal pressure may fall. (gastrotraining.com)
Mortality5
- Mortality was greater in patients with greater severity of HE (Grade 0/1: 16/48 (33%) Grade Tipifarnib 2: 19/32 (59%) Grade 3-4 16/21 (76%), p = 0.002). (c-metinhibitors.com)
- The risk of bacterial infection and mortality are very low in patients with Child-Pugh A cirrhosis, but more prospective studies are still needed to assess whether antibiotic prophylaxis can be avoided in this subgroup of patients. (thesecretsofmedicine.com)
- It is not clear if the higher mortality seen in LIMC's is due to patient demographics, severity on presentation, etiology or compliance with care standards. (researchsquare.com)
- Other potential contributors to the higher mortality may be the severity of disease presentation, as there is little primary care in our setting, and many patients seek care very late in their disease. (researchsquare.com)
- Therefore, preemptive TIPS must be placed in these high-risk patients as soon as possible to prevent re-bleeding, failure, and mortality. (cookmedical.eu)
Significant3
- There were no significant differences in the LPR or LSPS between alcoholic and viral cirrhosis groups, and the areas under the curves for the LPR and LSPS in subgroups according to HVPG levels were not superior to that for LS. (elsevierpure.com)
- A total of 32.8% of patients had at least fibrosis grade 2, including 10.3% with transient elastography of 9 kPa or greater, compatible with significant fibrosis. (e-cmh.org)
- At the beginning, the main focus was to reduce the burden of liver biopsy by confidently identifying patients who are very unlikely to have significant fibrosis on one hand and those who are very likely to have advanced fibrosis or cirrhosis on the other. (e-cmh.org)
Fibrosis2
- Dysbalance of hormonal homeostasis is critically involved in development and progression of portal hypertension (PH) and may also influence liver fibrosis. (meduniwien.ac.at)
- All patients who lost more than 10% of their weight had a 90% complete resolution of their NASH as well as an improvement of fibrosis in 45% [ 8 ]. (e-cmh.org)
Liver failure3
- TIPS reduces portal pressure and increases effective blood volume and cardiac output, but long-term adverse effects may include increased risk of liver failure, hepatic encephalopathy, and cardiac dysfunction. (emjreviews.com)
- interquartile range, 2.5-11.1 mo) varied widely as did clinical presentation, which was characterized by a variable association of liver failure and portal hypertension and different disease pro-gression rates. (ectrx.org)
- In patients fulfilling the criteria for pre-emptive TIPS, acute-on-chronic liver failure, hepatic encephalopathy at admission and hyperbilirubinemia at admission should not be considered contraindications. (thesecretsofmedicine.com)
Disease9
- While many studies have investigated the levels of different hormones in patients with advanced chronic liver disease (ACLD), there have not yet been more comprehensive studies, investigating patterns of hormonal dysregulation in different stages of PH and ACLD. (meduniwien.ac.at)
- Individualized treatment options for patients with non-cirrhotic and cirrhotic liver disease. (meduniwien.ac.at)
- Open angle glaucoma is painless and patients may be unaware of damage until relatively late in disease progression. (pharmacology2000.com)
- for example, in high-risk patients TIPS may offer clinical benefits when performed early in the disease course. (emjreviews.com)
- In the era of Interferon free oral combination therapy with direct antiviral agents (DAAs), patients with compensated and decompensated liver cirrhosis have been the first to receive therapy due to the severity of the liver disease and the high rates of Sustained Virologic response (SVR) with DAAs. (hcv-trials.com)
- Current indications for simvastatin are hypercholesterolemia and reduction in risk for death from coronary, cerebrovascular and peripheral artery disease in patients with these diseases. (nih.gov)
- 1 2 Non-alcoholic fatty liver disease (NAFLD) affects 15-40% of the general population and is particularly prevalent in patients with diabetes and obesity. (e-cmh.org)
- Six patients (85.7%) presented with veno-occlusive disease after a previous episode of acute cellular rejection. (ectrx.org)
- A tailored approach based on clinical features and including retransplant can achieve acceptable long-term survival in patients with veno-occlusive disease after liver transplant. (ectrx.org)
Plasma1
- Circulating plasma microbiome profiles in patients with cirrhosis were distinct from those of the controls and were characterized by enrichment of Comamonas, Cnuella, Dialister, Escherichia/Shigella, and Prevotella and the depletion of Bradyrhizobium, Curvibacter, Diaphorobacter, Pseudarcicella, and Pseudomonas. (bvsalud.org)
Etiology2
- We investigated the correlation between the value of LS, LS to platelet ratio (LPR), LS-spleen diameter-to-platelet ratio score (LSPS) and HVPG according to the etiology of cirrhosis, especially focused on alcoholic cirrhosis. (elsevierpure.com)
- We evaluated LS, LPR, and LSPS according to the etiology of cirrhosis and analyzed their correlations with HVPG. (elsevierpure.com)
Stratification2
- Further research and patient stratification are necessary to enhance understanding of the optimal use of covered TIPS and to ensure that the right patients receive TIPS at the right time. (emjreviews.com)
- Gastroenterol, 2021), patient stratification helps to clearly identify patients who will benefit from an early intervention. (cookmedical.eu)
Outcome1
- There is a paucity of data on the profile and outcome of patients who present with UGIB to EDs, especially within limited resource settings where emergency medicine is a new specialty. (researchsquare.com)
Markedly1
- LSM and ELF decreased markedly after SVR but did not correlate with HVPG response. (novartis.com)
Asymptomatic2
- Some patients with cirrhosis are completely asymptomatic and have a reasonably normal life expectancy. (medscape.com)
- HCV has been described as the "shadow epidemic" because of the insidious nature of the infection which is generally asymptomatic and persists for life in 85% of patients infected with the virus. (singhealth.com.sg)
Aims1
- The three independent aims of this project include the characterization of (i) vasoactive hormones in distinct stages of portal hypertension (PH), (ii) activation patterns of the classical and non-classical RAAS in different stages of ACLD and (iii) the hypothalamic-pituitary-adrenal (HPA) axis across ACLD stages. (meduniwien.ac.at)