Changes in SSM Assessed via 100 Hz ‐ VCTE Are Associated With Acute HVPG ‐Response to i.v. Propranolol: A European Multicentre Study

作者：Paul Thöne, Dario Saltini, Joana Calvão, Lorenz Balcar, Tomas Guasconi, Georg Semmler, Paula Höfinger, Barbara Datterl, Albert Friedrich Stättermayer, Michael Trauner, Thomas Reiberger, José Presa, Filippo Schepis, Mattias Mandorfer, Mathias Jachs · 发表于：Liver International · 年份：2026 · DOI：10.1111/liv.70778 · 研究领域：Liver Disease and Transplantation、Hemodynamic Monitoring and Therapy、Non-Invasive Vital Sign Monitoring

BACKGROUND: The acute hepatic venous pressure gradient (HVPG)-response to i.v. propranolol predicts outcomes in patients with advanced chronic liver disease (ACLD) and clinically significant portal hypertension (CSPH). While non-invasive tests (NIT) to monitor non-selective beta-blocker (NSBB)-induced HVPG changes are lacking, spleen stiffness measurement (SSM) has shown promising results as a surrogate for HVPG. This study aimed to assess the correlation between changes in SSM at 100 Hz and HVPG upon acute i.v. propranolol. METHODS: ACLD patients with CSPH undergoing paired HVPG and SSM-100 Hz assessments pre- and post-i.v. propranolol (0.15 mg/kg) at three expert centres between 2019 and 2024 were included. HVPG-response was defined as a ≥ 10% decrease in HVPG. RESULTS: ) were included. Most had alcohol-related liver disease (ALD)/metabolic-associated liver disease (59.6%) or metabolic-associated steatotic liver disease (11.7%). The median HVPG decreased from 17 (Q1-Q3: 15-20) mmHg to 16 (Q1-Q3: 12-19) mmHg post-NSBB (p < 0.001), with 45.7% achieving an acute HVPG-response. SSM decreased by -8.7 ([Q1-Q3: -19.2; -0.2] kPa, p < 0.001). HVPG-responders had a significant SSM decrease (-12.4 [Q1-Q3: -26.3; -5.6] kPa, p < 0.001), while non-responders showed no change. A moderate correlation between relative changes in SSM and HVPG was observed (Spearman's ρ: 0.387; p < 0.001). Relative change in SSM achieved an area under the receiver operating characteristic curve (AUROC) of 0.7...