<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03766880</url>
  </required_header>
  <id_info>
    <org_study_id>CHESS1802</org_study_id>
    <nct_id>NCT03766880</nct_id>
  </id_info>
  <brief_title>MR-based Models for Clinically Significant Portal Hypertension in Cirrhosis (CHESS1802)</brief_title>
  <official_title>MR-based Models for Noninvasive Detection of Clinically Significant Portal Hypertension in Cirrhosis (CHESS1802)</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Nanfang Hospital, Southern Medical University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Zhongda Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Beijing 302 Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Affiliated Lishui Hospital of Zhejiang University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Shandong Provincial Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Xingtai People's Hospital</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>The First Hospital of Zhengzhou University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Shanghai Public Health Clinical Center, Fudan University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>LanZhou University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Southern Medical University, China</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Ankara University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Nanfang Hospital, Southern Medical University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Clinically significant portal hypertension (CSPH) is associated with an incremental risk of&#xD;
      esophageal varices and overt clinical decompensations in cirrhosis. However, hepatic venous&#xD;
      pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥ 10mmHg) is&#xD;
      invasive and therefore not suitable for routine clinical practice.&#xD;
&#xD;
      This is a multi-center diagnostic trial conducted at high-volume liver centres designed to&#xD;
      determine the accuracy of MR-based models (investigational technology) for noninvasive&#xD;
      detection of a CSPH in patients with cirrhosis. Transjugular HVPG measurement by means of&#xD;
      catheterization of a hepatic vein with a balloon catheter is the gold-standard method to&#xD;
      assess the presence of CSPH.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Clinically significant portal hypertension (CSPH) is associated with an incremental risk of&#xD;
      esophageal varices and overt clinical decompensations in cirrhosis. However, hepatic venous&#xD;
      pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥ 10mmHg) is&#xD;
      invasive and therefore not suitable for routine clinical practice.&#xD;
&#xD;
      This is a multi-center diagnostic trial conducted at high-volume liver centres (Zhongda&#xD;
      Hospital, Medical School of Southeast University; Affiliated Lishui Hospital of Zhejiang&#xD;
      University; Shandong Provincial Hospital affiliated to Shandong University; Beijing 302&#xD;
      Hospital; Xingtai People's Hospital; Shunde Hospital, Southern Medical University; The First&#xD;
      Hospital of Zhengzhou University; Shanghai Public Health Clinical Center, Fudan University;&#xD;
      The First Hospital of Lanzhou University; Nanfang Hospital of Southern Medical University;&#xD;
      Ankara University School of Medicine) designed to determine the accuracy of MR-based models&#xD;
      (investigational technology) for noninvasive detection of a CSPH in patients with cirrhosis.&#xD;
      Transjugular HVPG measurement by means of catheterization of a hepatic vein with a balloon&#xD;
      catheter is the gold-standard method to assess the presence of CSPH.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">December 4, 2018</start_date>
  <completion_date type="Actual">April 30, 2019</completion_date>
  <primary_completion_date type="Actual">April 30, 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Diagnostic</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Diagnostic Performance of MR-based Models</measure>
    <time_frame>1 day</time_frame>
    <description>Accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MR-based models for noninvasive detection of CSPH when compared to HVPG as the reference standard.</description>
  </primary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Actual">175</enrollment>
  <condition>Hypertension, Portal</condition>
  <arm_group>
    <arm_group_label>Single arm study</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Participants will receive MR imaging, transjugular HVPG measurement, and analysis per protocol.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Transjugular HVPG measurement</intervention_name>
    <description>By means of catheterization of a hepatic vein with a balloon catheter.</description>
    <arm_group_label>Single arm study</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>MR imaging</intervention_name>
    <description>MR images for the post-processing analysis</description>
    <arm_group_label>Single arm study</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Age 18-75 years&#xD;
&#xD;
          -  With written informed consent&#xD;
&#xD;
          -  Confirmed liver cirrhosis based on liver biopsy or clinical findings&#xD;
&#xD;
          -  Scheduled to undergo clinically-indicated transjugular HVPG measurement by means of&#xD;
             catheterization of a hepatic vein with a balloon catheter&#xD;
&#xD;
          -  Has undergone&gt; MR imaging within 14 days to hepatic vein catheterization&#xD;
&#xD;
          -  No hepatic-portal vein interventional therapy between MR imaging and hepatic vein&#xD;
             catheterization&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  A contraindication to MR imaging, in particular pacemakers or implantable&#xD;
             defibrillators, cochlear implants, neurosurgical clips, intra-orbital or brain&#xD;
             metallic foreign bodies, endo prothesis since less than 4 weeks or osteosynthesis&#xD;
             material since less than 6 weeks&#xD;
&#xD;
          -  Unable to comply with breathing or other imaging related instructions resulting in&#xD;
             inability to obtain diagnostic quality MR imaging studies&#xD;
&#xD;
          -  Contraindication to the injection of contrast agent: pregnancy, lactation, history of&#xD;
             allergic reaction to contrast agent injection.&#xD;
&#xD;
          -  Prior transjugular intrahepatic portosystem stent-shunt surgery&#xD;
&#xD;
          -  Prior devascularization operation&#xD;
&#xD;
          -  Has received a liver transplant&#xD;
&#xD;
          -  Any active, serious, life-threatening disease&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>75 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Xiaolong Qi, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Nanfang Hospital, Southern Medical University</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Shenghong Ju, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Zhongda Hospital</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Beijing 302 Hospital</name>
      <address>
        <city>Beijing</city>
        <state>Beijing</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The First Hospital of Lanzhou University</name>
      <address>
        <city>Lanzhou</city>
        <state>Gansu</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nanfang Hospital of Southern Medical University</name>
      <address>
        <city>Guangzhou</city>
        <state>Guangdong</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Shunde Hospital, Southern Medical University</name>
      <address>
        <city>Shunde</city>
        <state>Guangdong</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Xingtai People's Hospital</name>
      <address>
        <city>Xingtai</city>
        <state>Hebei</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The First Hospital of Zhengzhou University</name>
      <address>
        <city>Zhengzhou</city>
        <state>Henan</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Zhongda Hospital, Medical School of Southeast University</name>
      <address>
        <city>Nanjing</city>
        <state>Jiangsu</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Shandong Provincial Hospital affiliated to Shandong University</name>
      <address>
        <city>Jinan</city>
        <state>Shandong</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Shanghai Public Health Clinical Center, Fudan University</name>
      <address>
        <city>Shanghai</city>
        <state>Shanghai</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Affiliated Lishui Hospital of Zhejiang University</name>
      <address>
        <city>Lishui</city>
        <state>Zhejiang</state>
        <country>China</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ankara University School of Medicine</name>
      <address>
        <city>Ankara</city>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>China</country>
    <country>Turkey</country>
  </location_countries>
  <reference>
    <citation>Qi X, Berzigotti A, Cardenas A, Sarin SK. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018 Oct;3(10):708-719. doi: 10.1016/S2468-1253(18)30232-2.</citation>
    <PMID>30215362</PMID>
  </reference>
  <reference>
    <citation>Sun R, Limkin EJ, Vakalopoulou M, Dercle L, Champiat S, Han SR, Verlingue L, Brandao D, Lancia A, Ammari S, Hollebecque A, Scoazec JY, Marabelle A, Massard C, Soria JC, Robert C, Paragios N, Deutsch E, Ferte C. A radiomics approach to assess tumour-infiltrating CD8 cells and response to anti-PD-1 or anti-PD-L1 immunotherapy: an imaging biomarker, retrospective multicohort study. Lancet Oncol. 2018 Sep;19(9):1180-1191. doi: 10.1016/S1470-2045(18)30413-3. Epub 2018 Aug 14.</citation>
    <PMID>30120041</PMID>
  </reference>
  <reference>
    <citation>Liu F, Ning Z, Liu Y, Liu D, Tian J, Luo H, An W, Huang Y, Zou J, Liu C, Liu C, Wang L, Liu Z, Qi R, Zuo C, Zhang Q, Wang J, Zhao D, Duan Y, Peng B, Qi X, Zhang Y, Yang Y, Hou J, Dong J, Li Z, Ding H, Zhang Y, Qi X. Development and validation of a radiomics signature for clinically significant portal hypertension in cirrhosis (CHESS1701): a prospective multicenter study. EBioMedicine. 2018 Oct;36:151-158. doi: 10.1016/j.ebiom.2018.09.023. Epub 2018 Sep 27.</citation>
    <PMID>30268833</PMID>
  </reference>
  <reference>
    <citation>Wang K, Lu X, Zhou H, Gao Y, Zheng J, Tong M, Wu C, Liu C, Huang L, Jiang T, Meng F, Lu Y, Ai H, Xie XY, Yin LP, Liang P, Tian J, Zheng R. Deep learning Radiomics of shear wave elastography significantly improved diagnostic performance for assessing liver fibrosis in chronic hepatitis B: a prospective multicentre study. Gut. 2019 Apr;68(4):729-741. doi: 10.1136/gutjnl-2018-316204. Epub 2018 May 5.</citation>
    <PMID>29730602</PMID>
  </reference>
  <reference>
    <citation>de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 Sep;63(3):743-52. doi: 10.1016/j.jhep.2015.05.022. Epub 2015 Jun 3. No abstract available.</citation>
    <PMID>26047908</PMID>
  </reference>
  <reference>
    <citation>Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology. 2017 Jan;65(1):310-335. doi: 10.1002/hep.28906. Epub 2016 Dec 1. No abstract available. Erratum In: Hepatology. 2017 Jul;66(1):304.</citation>
    <PMID>27786365</PMID>
  </reference>
  <reference>
    <citation>Gillies RJ, Kinahan PE, Hricak H. Radiomics: Images Are More than Pictures, They Are Data. Radiology. 2016 Feb;278(2):563-77. doi: 10.1148/radiol.2015151169. Epub 2015 Nov 18.</citation>
    <PMID>26579733</PMID>
  </reference>
  <reference>
    <citation>Lambin P, Leijenaar RTH, Deist TM, Peerlings J, de Jong EEC, van Timmeren J, Sanduleanu S, Larue RTHM, Even AJG, Jochems A, van Wijk Y, Woodruff H, van Soest J, Lustberg T, Roelofs E, van Elmpt W, Dekker A, Mottaghy FM, Wildberger JE, Walsh S. Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017 Dec;14(12):749-762. doi: 10.1038/nrclinonc.2017.141. Epub 2017 Oct 4.</citation>
    <PMID>28975929</PMID>
  </reference>
  <verification_date>August 2019</verification_date>
  <study_first_submitted>December 4, 2018</study_first_submitted>
  <study_first_submitted_qc>December 4, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 6, 2018</study_first_posted>
  <last_update_submitted>August 26, 2019</last_update_submitted>
  <last_update_submitted_qc>August 26, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">August 28, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Nanfang Hospital, Southern Medical University</investigator_affiliation>
    <investigator_full_name>Xiaolong Qi</investigator_full_name>
    <investigator_title>Director, Hepatic Hemodynamic Lab</investigator_title>
  </responsible_party>
  <keyword>clinically significant portal hypertension, hepatic venous pressure gradient, MR imaging</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Hypertension, Portal</mesh_term>
    <mesh_term>Hypertension</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03766880
org study id: CHESS1802
nct id: NCT03766880
lead sponsor: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Clinically significant portal hypertension (CSPH) is associated with an incremental risk of
      esophageal varices and overt clinical decompensations in cirrhosis. However, hepatic venous
      pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥ 10mmHg) is
      invasive and therefore not suitable for routine clinical practice.

      This is a multi-center diagnostic trial conducted at high-volume liver centres designed to
      determine the accuracy of MR-based models (investigational technology) for noninvasive
      detection of a CSPH in patients with cirrhosis. Transjugular HVPG measurement by means of
      catheterization of a hepatic vein with a balloon catheter is the gold-standard method to
      assess the presence of CSPH.
Clinically significant portal hypertension (CSPH) is associated with an incremental risk of
      esophageal varices and overt clinical decompensations in cirrhosis. However, hepatic venous
      pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥ 10mmHg) is
      invasive and therefore not suitable for routine clinical practice.

      This is a multi-center diagnostic trial conducted at high-volume liver centres (Zhongda
      Hospital, Medical School of Southeast University; Affiliated Lishui Hospital of Zhejiang
      University; Shandong Provincial Hospital affiliated to Shandong University; Beijing 302
      Hospital; Xingtai People's Hospital; Shunde Hospital, Southern Medical University; The First
      Hospital of Zhengzhou University; Shanghai Public Health Clinical Center, Fudan University;
      The First Hospital of Lanzhou University; Nanfang Hospital of Southern Medical University;
      Ankara University School of Medicine) designed to determine the accuracy of MR-based models
      (investigational technology) for noninvasive detection of a CSPH in patients with cirrhosis.
      Transjugular HVPG measurement by means of catheterization of a hepatic vein with a balloon
      catheter is the gold-standard method to assess the presence of CSPH.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Diagnostic
masking: None (Open Label)
measure: Diagnostic Performance of MR-based Models
time frame: 1 day
description: Accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MR-based models for noninvasive detection of CSPH when compared to HVPG as the reference standard.
arm group label: Single arm study
arm group type: Experimental
description: Participants will receive MR imaging, transjugular HVPG measurement, and analysis per protocol.
intervention type: Procedure
intervention name: Transjugular HVPG measurement
description: By means of catheterization of a hepatic vein with a balloon catheter.
arm group label: Single arm study
intervention type: Procedure
intervention name: MR imaging
description: MR images for the post-processing analysis
arm group label: Single arm study
criteria: 
gender: All
minimum age: 18 Years
maximum age: 75 Years
healthy volunteers: No
last name: Xiaolong Qi, MD
role: Principal Investigator
affiliation: Nanfang Hospital, Southern Medical University
last name: Shenghong Ju, MD
role: Principal Investigator
affiliation: Zhongda Hospital
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
facility: 
country: China
country: Turkey
citation: Qi X, Berzigotti A, Cardenas A, Sarin SK. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018 Oct;3(10):708-719. doi: 10.1016/S2468-1253(18)30232-2.
PMID: 30215362
citation: Sun R, Limkin EJ, Vakalopoulou M, Dercle L, Champiat S, Han SR, Verlingue L, Brandao D, Lancia A, Ammari S, Hollebecque A, Scoazec JY, Marabelle A, Massard C, Soria JC, Robert C, Paragios N, Deutsch E, Ferte C. A radiomics approach to assess tumour-infiltrating CD8 cells and response to anti-PD-1 or anti-PD-L1 immunotherapy: an imaging biomarker, retrospective multicohort study. Lancet Oncol. 2018 Sep;19(9):1180-1191. doi: 10.1016/S1470-2045(18)30413-3. Epub 2018 Aug 14.
PMID: 30120041
citation: Liu F, Ning Z, Liu Y, Liu D, Tian J, Luo H, An W, Huang Y, Zou J, Liu C, Liu C, Wang L, Liu Z, Qi R, Zuo C, Zhang Q, Wang J, Zhao D, Duan Y, Peng B, Qi X, Zhang Y, Yang Y, Hou J, Dong J, Li Z, Ding H, Zhang Y, Qi X. Development and validation of a radiomics signature for clinically significant portal hypertension in cirrhosis (CHESS1701): a prospective multicenter study. EBioMedicine. 2018 Oct;36:151-158. doi: 10.1016/j.ebiom.2018.09.023. Epub 2018 Sep 27.
PMID: 30268833
citation: Wang K, Lu X, Zhou H, Gao Y, Zheng J, Tong M, Wu C, Liu C, Huang L, Jiang T, Meng F, Lu Y, Ai H, Xie XY, Yin LP, Liang P, Tian J, Zheng R. Deep learning Radiomics of shear wave elastography significantly improved diagnostic performance for assessing liver fibrosis in chronic hepatitis B: a prospective multicentre study. Gut. 2019 Apr;68(4):729-741. doi: 10.1136/gutjnl-2018-316204. Epub 2018 May 5.
PMID: 29730602
citation: de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015 Sep;63(3):743-52. doi: 10.1016/j.jhep.2015.05.022. Epub 2015 Jun 3. No abstract available.
PMID: 26047908
citation: Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology. 2017 Jan;65(1):310-335. doi: 10.1002/hep.28906. Epub 2016 Dec 1. No abstract available. Erratum In: Hepatology. 2017 Jul;66(1):304.
PMID: 27786365
citation: Gillies RJ, Kinahan PE, Hricak H. Radiomics: Images Are More than Pictures, They Are Data. Radiology. 2016 Feb;278(2):563-77. doi: 10.1148/radiol.2015151169. Epub 2015 Nov 18.
PMID: 26579733
citation: Lambin P, Leijenaar RTH, Deist TM, Peerlings J, de Jong EEC, van Timmeren J, Sanduleanu S, Larue RTHM, Even AJG, Jochems A, van Wijk Y, Woodruff H, van Soest J, Lustberg T, Roelofs E, van Elmpt W, Dekker A, Mottaghy FM, Wildberger JE, Walsh S. Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017 Dec;14(12):749-762. doi: 10.1038/nrclinonc.2017.141. Epub 2017 Oct 4.
PMID: 28975929
responsible party type: Principal Investigator
investigator affiliation: Nanfang Hospital, Southern Medical University
investigator full name: Xiaolong Qi
investigator title: Director, Hepatic Hemodynamic Lab
mesh term: Hypertension, Portal
mesh term: Hypertension
sharing ipd: Undecided