International Journal of Medical Sciences

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17 October 2017

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Int J Med Sci 2017; 14(9):804-810. doi:10.7150/ijms.19847

Research Paper

Compensating effect of minor portal hypertension on the muscle mass loss-related poor prognosis in cirrhosis

Hitoshi Maruyama1✉, Kazufumi Kobayashi1, Soichiro Kiyono1, Sadahisa Ogasawara1, Eichiro Suzuki1, Yoshihiko Ooka1, Tetsuhiro Chiba1, Tadashi Yamaguchi2

1. Department of Gastroenterology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670, Japan;
2. Department of Research Center for Frontier Medical Engineering, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba, 263-8522, Japan.

Abstract

Background: To examine the influence of the severity of portal hemodynamic abnormality on the prognosis of cirrhosis with respect to the muscle mass loss (MML).

Methods: The study involved a subgroup analysis in 98 cirrhosis patients (63.5 ± 11.8 years) who prospectively underwent both Doppler ultrasound and hepatic venous catheterization. The prognostic influence of MML diagnosed by computed tomography using the L3 skeletal muscle index was evaluated (median observation period, 32.7 months).

Results: The cumulative survival rate showed difference between patients with MML (n = 34; 82.2%/1year, 41.2%/3years and 36.1%/5years) and those without (n = 64; 92.1%/1year, 74.9%/3years and 69.4%/5years; P = 0.005). When divided with respect to the portal velocity, the survival rate showed differences between patients with and without MML in the cohort < 12.8 cm/s (n=52, p=0.009) and ≥ 12.8 cm/s (n=44, p=0.041). The survival rate also showed differences between patients with MML (n = 24; 78.8%/1year, 40.6%/3years and 34.8%/5years) and those without (n = 45; 91.1%/1year, 71.3%/3years and 63.1%/5years; P = 0.008) in the cohort with hepatic venous pressure gradient (HVPG) > 12 mmHg. However, in the cohort with HVPG ≤ 12 mmHg, survival rate showed no difference between patients with MML (n=10; 100%/1year, 61.9%/3years and 61.9%/5years) and those without (n=19; 93.8%/1year, 71.2%/3years and 59.4%/5years; p = 0.493)

Conclusion: Lower HVPG has a compensating effect on the MML-induced poor prognosis of cirrhosis. Care should be taken in the evaluation of the influence of MML in consideration of the severity of portal hypertension.

Keywords: Muscle mass loss, portal hypertension, cirrhosis, hepatic venous pressure gradient

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How to cite this article:
Maruyama H, Kobayashi K, Kiyono S, Ogasawara S, Suzuki E, Ooka Y, Chiba T, Yamaguchi T. Compensating effect of minor portal hypertension on the muscle mass loss-related poor prognosis in cirrhosis. Int J Med Sci 2017; 14(9):804-810. doi:10.7150/ijms.19847. Available from http://www.medsci.org/v14p0804.htm