BACKGROUND Portal hypertension,a common complication associated with liver cirrhosis,can result in variceal bleeding,which greatly impacts patient survival.Recently,β-arrestin-2 has been shown to predict the acute he...BACKGROUND Portal hypertension,a common complication associated with liver cirrhosis,can result in variceal bleeding,which greatly impacts patient survival.Recently,β-arrestin-2 has been shown to predict the acute hemodynamic response to nonselectiveβ-blocker therapy for cirrhotic portal hypertension.However,more data is needed on the long-term effects of and changes inβ-arrestin-2 following nonselectiveβ-blocker therapy.AIM To investigate the expression and role ofβ-Arrestin-2 in predicting the long-term response to nonselectiveβ-blockers in cirrhotic portal hypertensive patients.METHODS We prospectively enrolled 91 treatment-naïve patients with cirrhotic portal hypertension.Baseline clinical and laboratory data were obtained.Gastroscopy was performed for grading and treating varices and obtaining gastric antral biopsies.We measured the serum and antral expression ofβ-arrestin-2 and obtained Doppler measurement of the portal vein congestion index.Treatment with nonselectiveβ-blockers was then started.The patients were followed up for 18 mo,after which they have undergone a repeat antral biopsy and re-evaluation of the portal vein congestion index.RESULTS A higher serum level and antral expression ofβ-arrestin-2 was associated with longer bleedingfree intervals,greater reduction in the portal vein congestion index,and improved grade of varices.Among patients with a lowβ-arrestin-2 expression,17.6%were nonselectiveβ-blocker responders,whereas,among those with high expression,95.1%were responders(P<0.001).A serumβ-arrestin-2 value≥2.23 ng/mL was associated with a lower likelihood of variceal bleeding(90%sensitivity and 71%specificity).β-arrestin-2 expression significantly decreased after nonselectiveβ-blocker therapy.CONCLUSIONβ-arrestin-2 expression in cirrhotic portal hypertension predicts the clinical response to long-term nonselectiveβ-blocker treatment.Serumβ-arrestin-2 is a potential noninvasive biomarker for selecting the candidate patients for nonselectiveβ-blockers.展开更多
文摘BACKGROUND Portal hypertension,a common complication associated with liver cirrhosis,can result in variceal bleeding,which greatly impacts patient survival.Recently,β-arrestin-2 has been shown to predict the acute hemodynamic response to nonselectiveβ-blocker therapy for cirrhotic portal hypertension.However,more data is needed on the long-term effects of and changes inβ-arrestin-2 following nonselectiveβ-blocker therapy.AIM To investigate the expression and role ofβ-Arrestin-2 in predicting the long-term response to nonselectiveβ-blockers in cirrhotic portal hypertensive patients.METHODS We prospectively enrolled 91 treatment-naïve patients with cirrhotic portal hypertension.Baseline clinical and laboratory data were obtained.Gastroscopy was performed for grading and treating varices and obtaining gastric antral biopsies.We measured the serum and antral expression ofβ-arrestin-2 and obtained Doppler measurement of the portal vein congestion index.Treatment with nonselectiveβ-blockers was then started.The patients were followed up for 18 mo,after which they have undergone a repeat antral biopsy and re-evaluation of the portal vein congestion index.RESULTS A higher serum level and antral expression ofβ-arrestin-2 was associated with longer bleedingfree intervals,greater reduction in the portal vein congestion index,and improved grade of varices.Among patients with a lowβ-arrestin-2 expression,17.6%were nonselectiveβ-blocker responders,whereas,among those with high expression,95.1%were responders(P<0.001).A serumβ-arrestin-2 value≥2.23 ng/mL was associated with a lower likelihood of variceal bleeding(90%sensitivity and 71%specificity).β-arrestin-2 expression significantly decreased after nonselectiveβ-blocker therapy.CONCLUSIONβ-arrestin-2 expression in cirrhotic portal hypertension predicts the clinical response to long-term nonselectiveβ-blocker treatment.Serumβ-arrestin-2 is a potential noninvasive biomarker for selecting the candidate patients for nonselectiveβ-blockers.
