Doppler Ultrasound Hepatic Vein Waveform as a Non-invasive Tool in the Assessment of Severity of Portal Hypertension

• Status: Unknown status
• Trial end date: 2018-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Portal hypertension is the result of an increased hepatic vascular resistance and portal inflow. The best established method to assess portal pressures is the determination of wedged hepatic venous pressure gradient (HVPG). Ultrasound Doppler technique is non-invasive in the assessment of portal hypertension as compared with invasive technique of measurement of the hepatic venous pressure gradient (HVPG). Hemodynamic measurements (BP and pulse recording) will be done and then patient will be given tablet Carvedilol 12.5 mg in a single dose and wait till the time that 20% reduction in heart rate from the baseline occurs. Haemodynamic measurements will be repeated to assess the acute response to beta-adrenoreceptor blocker agent. The change in the HWF will be recorded post beta-adrenoreceptor blocker administration.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Aga Khan University
• Collaborator: Dow University of Health Sciences
• Treatments: Carvedilol

Criteria

Inclusion Criteria:

• Patients with cirrhosis and large varices (≥ 5mm) on screening endoscopy

• Not known esophageal or gastric variceal bleed

Exclusion Criteria:

• Small esophageal varices (<5 mm in size) on screening endoscopy

• Hemodynamically unstable i.e. Blood pressure of <90mmHg and tachycardia of >100bpm.

• Contraindication to Beta-blockers (Asthma, bradycardia, heart failure, allergy)

• history of Esophageal or gastric variceal bleed in the past

• Hepatocellular carcinoma or other metastatic malignancy.

• Portal vein thrombosis (PVT) or Inferior venacaval (IVC) thrombosis

• Congestive cardiac failure (CCF)

• Renal failure or Hepatorenal syndrome (Creatine of >1.5 mg/dl)

• Previous allergy to IV contrast agent.

• Lactating or Pregnant women