***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background / Aims We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system ( USSS ) combining six representative sonographic indices with that of liver stiffness measurement ( LSM ) by transient elastography , and prospect ively investigated the correlation between the USSS score and LSM in predicting cirrhosis . Methods Two hundred and thirty patients with chronic liver diseases ( 187 men , 43 women ; age , 50.4±9.5 y , mean±SD ) were enrolled in this prospect i ve study . The USSS produces a combined score for nodularity of the liver surface and edge , parenchyma echogenicity , presence of right-lobe atrophy , spleen size , splenic vein diameter , and abnormality of the hepatic vein waveform . The correlations of the USSS score  and LSM with that of a pathological liver biopsy ( METAVIR scoring system : F0-F4 ) were evaluated . Results The mean USSS score and LSM were 7.2 and 38.0 kPa , respectively , in patients with histologically overt cirrhosis ( F4 , P=0.017 ) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis ( F0-F3 ) ( P=0.025 ) . The areas under the receiver operating characteristic ( ROC ) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729 , respectively . On the basis of ROC curves , criteria of USSS ≥6 : LSM ≥17.4 had a sensitivity , specificity , positive predictive value , negative predictive value , and accuracy of 89.2%:77.6 % , 69.4%:61.4 % , 86.5%:83.7 % , 74.6%:51.9 % and 0.83:0.73 , respectively , in predicting F4 . Conclusions The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis BACKGROUND / AIM The study was design ed to assess to what extent portal hemodynamic parameters obtained by duplex Doppler ultrasonography may be substituted for the measurement of hepatic venous pressure gradient in evaluating the severity of portal hypertension and the response to medical treatment with beta-blockers or beta-blockers plus nitrates in patients with cirrhosis and portal hypertension . METHODS In 39 of these patients hepatic venous pressure gradient was determined by hepatic vein catheterization , and portal blood flow velocity and the congestion index of the portal vein were measured by duplex Doppler ultrasonography . In 19 of these patients the changes in hepatic venous pressure gradient and in Doppler parameters were also assessed after chronic administration of nadolol . In 11 of the 19 patients the changes after chronic administration of nadolol plus isosorbide-5-mononitrate were also measured . RESULTS In the whole series , no significant correlation was found between hepatic venous pressure gradient and duplex Doppler parameters , but , when the 12 patients with a patent para-umbilical vein were excluded , significant linear correlations were found between hepatic venous pressure gradient and portal blood velocity ( r=-0.39 ; p=0.05 ) or congestion index ( r=0.37 ; p=0.05 ) . Considering together the changes induced by nadolol and nadolol plus isosorbide-5-mononitrate , no correlation was apparent between changes in duplex Doppler parameters and in hepatic venous pressure gradient . Agreement between hepatic venous pressure gradient and duplex Doppler parameters in defining good and poor responders was insufficient . CONCLUSIONS These data suggest that portal blood velocity and the congestion index of the portal vein are related to portal hypertension in patients without a patent para-umbilical vein , but are of limited value in discriminating good responders from poor responders to medical treatment for portal hypertension Background The effect of an angiotensin II blockade in lowering the portal pressure in patients with liver cirrhosis and portal hypertension is controversial . This prospect i ve study was undertaken to evaluate the portal hypotensive effect of captopril compared to that of propranolol , and to determine the factors that contribute to a successful reduction in the portal pressure after longterm captopril administration in patients with liver cirrhosis . Methods The hepatic venous pressure gradient ( HVPG ) and portal venous velocity ( PVV ) were measured both before and 3 months after initiation of the administration of captopril  ( n = 29 ) or propranolol  ( n = 29 ) in cirrhotic patients with a variceal bleeding episode . Patients who showed a reduction in the HVPG of more than 20 % of the baseline were defined as being responders . Results At 3 months , the mean reduction in the HVPG  after captopril was less than that after propranolol ( −3.0 ± 9.3 % vs −28.5 % ± 4.1 % ; P ≪ 0.05 ) . However , of the 29 patients receiving captopril  , 9 were classified as being responders . On multivariate analysis with parameters including age , cause , Child-Pugh score , HVPG , and PVV , only low PVV was found to be a significant independent factor for responders ( PVV ≪ 12 cm/s ; odds ratio [ OR ] , 12.2 ; 95 % confidence interval [ CI ] , 1.47–102.40 ) in the captopril group . Conclusions Longterm captopril administration reduces the portal pressure effectively in cirrhotic patients with a low PVV . This suggests that the reduction in portal pressure  after captopril administration is a result of improved portal venous outflow brought about by a decrease in the intrahepatic vascular resistance . When the PVV is below 12 cm/s , a captopril trial might be useful in preventing variceal bleeding in portal hypertensive patients The drugs currently under investigation in the prevention of recurrent gastrointestinal bleeding in cirrhosis are likely to decrease the portal pressure by means of a primary reduction of portal blood flow . The hemodynamic effects of β‐blocking agents and vasodilatory drugs were noninvasively measured in eight patients with cirrhosis by means of pulsed echo‐doppler equipment . Portal caliber , blood velocity and flow were recorded hourly after a single dose of propranolol ( 40 mg p.o . ) or atenolol ( 100 mg p.o . ) , and every 5 min after treatment with isosorbide dinitrate ( 5 mg sublingually ) . The drugs were administered at r and om with an interval of 2 days or more . The portal caliber decreased after atenolol , but did not change after propranolol and isosorbide . The blood velocity decreased by 29 ± 2 % 3 hr after propranolol , by 26 ± 2 % 3 hr after atenolol and by 31 ± 3 % 15 min after isosorbide . The portal blood flow decreased by 0.29 ± 0.03 liters per min after propranolol , by 0.34 ± 0.06 after atenolol and by 0.26 ± 0.03 after isosorbide , without any difference among the various treatments . β‐blockers and vasodilatory drugs have comparable effects on portal blood flow . β1‐selective and nonselective β‐blockers are similarly effective in keeping with the hypothesis that changes in portal blood flow are mainly due to the block of β1‐receptors BACKGROUND : Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate . They purportedly act by mesenteric arterial vasoconstriction , thus reducing portal venous flow ( PVF ) and portal pressure . Little is known about the immediate-early hemodynamic effects of these drugs . AIM : To compare the acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis . PATIENTS : Forty-two cirrhotic patients with a history of variceal bleeding were r and omized to receive either octreotide 100 μg intravenous bolus followed by a continuous infusion at 250 μg/h ( n = 21 ) , or terlipressin 2 mg intravenous bolus ( n = 21 ) . METHODS : Mean arterial pressure ( MAP ) , heart rate ( HR ) , hepatic venous pressure gradient ( HVPG ) , and PVF , assessed by duplex Doppler ultrasonography , were measured before and at 1 , 5 , 10 , 15 , 20 , and 25 min after the start of drug administration . RESULTS : Octreotide markedly decreased HVPG ( −44.5 ± 17.8 % ) and PVF ( −30.6 ± 13.6 % ) compared to the baseline at 1 min ( p < 0.05 ) . Thereafter , both variables rapidly returned toward the baseline , and by 5 min , no significant differences in HVPG ( −7.1 ± 28.9 % ) and PVF ( 10.2 ± 26.2 % ) were noted . A similar transient effect on MAP and HR was observed . Terlipressin significantly decreased HVPG ( −18.3 ± 11.9 % ) and PVF ( −32.6 ± 10.5 % ) at 1 min ( p < 0.05 ) and sustained these effects at all time points . The effects on arterial pressure and HR were also sustained . CONCLUSIONS : Octreotide only transiently reduced portal pressure and flow , whereas the effects of terlipressin were sustained . These results suggest that terlipressin may have more sustained hemodynamic effects in patients with bleeding varices BACKGROUND / AIMS This prospect i ve study aim ed to determine if Doppler ultrasonography can be representative of hepatic venous pressure gradient ( HVPG ) in assessing the severity of portal hypertension and response to drug reducing portal pressure . METHODS The HVPG and the parameters of Doppler ultrasonography including portal venous velocity ( PVV ) and splenic venous velocity , the pulsatility and resistive index of hepatic , splenic and renal arteries were measured in 105 patients with liver cirrhosis . In 31 patients the changes of hepatic venous pressure gradient and portal venous velocity after administration of terlipressin were evaluated . The patients who showed a reduction in HVPG of more than 20 % of the baseline were defined as responders to terlipressin . RESULTS Any Doppler ultrasonographic parameters did not correlate with HVPG . Both HVPG and PVV showed a highly significant reduction after the administration of terlipressin(-28.3 + /- 3.9 % , -31.2 + /- 2.2 % respectively ) . However , PVV decreased significantly not only in responders(31.7 + /- 2.4 % ) but also in nonresponders(29.5 + /- 6.1 % ) . CONCLUSION Doppler ultrasonography can not be representative of HVPG in assessing the severity of portal hypertension and response to drug reducing portal pressure in liver cirrhosis BACKGROUND AND AIMS Our aim was to identify predictors of clinical decompensation ( defined as the development of ascites , variceal hemorrhage [ VH ] , or hepatic encephalopathy [ HE ] ) in patients with compensated cirrhosis and with portal hypertension as determined by the hepatic venous pressure gradient ( HVPG ) . METHODS We analyzed 213 patients with compensated cirrhosis and portal hypertension but without varices included in a trial evaluating the use of beta-blockers in preventing varices . All had baseline laboratory tests and HVPG . Patients were followed prospect ively every 3 months until development of varices or VH or end of study . To have complete information , until study termination , about clinical decompensation , medical record review was done . Patients who underwent liver transplantation without decompensation were censored at transplantation . Cox regression models were developed to identify predictors of clinical decompensation . Receiver operating characteristic ( ROC ) curves were constructed to evaluate diagnostic capacity of HVPG . RESULTS Median follow-up time of 51.1 months . Sixty-two ( 29 % ) of 213 patients developed decompensation : 46 ( 21.6 % ) ascites , 6 ( 3 % ) VH , 17 ( 8 % ) HE . Ten patients received a transplant and 12 died without clinical decompensation . Median HVPG at baseline was 11 mm Hg ( range , 6 - 25 mm Hg ) . On multivariate analysis , 3 predictors of decompensation were identified : HVPG ( hazard ratio [ HR ] , 1.11 ; 95 % confidence interval [ CI ] , 1.05 - 1.17 ) , model of end-stage liver disease ( MELD ) ( HR , 1.15 ; 95 % CI , 1.03 - 1.29 ) , and albumin ( HR , 0.37 ; 95 % CI , 0.22 - 0.62 ) . Diagnostic capacity of HVPG was greater than for MELD or Child-Pugh score . CONCLUSIONS HVPG , MELD , and albumin independently predict clinical decompensation in patients with compensated cirrhosis . Patients with an HVPG < 10 mm Hg have a 90 % probability of not developing clinical decompensation in a median follow-up of 4 years Background and aims : A reliable non-invasive assessment of the severity of diffuse liver disease is much needed . We investigated the utility of  hepatic vein 
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Conclusion Some US indices , such as HV , exhibited an increased accuracy for diagnosing PH .
These indices may be useful in clinical practice for the detection of significant PH