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Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension
İlhan Hekimsoy,Burçin Kibar Öztürk,Hatice Soner Kemal,Meral Kayıkçıoğlu,Ömer Faruk Dadaş,Gülgün Kavukçu,Mehmet Nurullah Orman,Sanem Nalbantgil,Sadık Tamsel,Hakan Kültürsay,Süha Süreyya Özbek 대한초음파의학회 2021 ULTRASONOGRAPHY Vol.40 No.2
Purpose: The aim of this study was to evaluate the associations of sonographic and sonoelastographic parameters with clinical cardiac parameters, as well as to assess their value in predicting survival in patients with pulmonary arterial hypertension (PAH). Methods: Thirty-six patients with PAH and normal liver function were prospectively enrolled in this prospective study along with 26 healthy controls, all of whom underwent ultrasound and point shear wave elastography examinations. Additionally, the portal vein pulsatility index (PVPI), inferior vena cava collapsibility index, and clinical cardiac variables were obtained in PAH patients. The values of hepatic (LVs) and splenic shear wave velocity (SVs) were compared between PAH patients and controls. The relationships between all sonographic and clinical parameters in the PAH patients were analyzed. Furthermore, their prognostic value in predicting survival was investigated. Results: LVs values in PAH patients (median, 1.62 m/s) were significantly higher than in controls (median, 0.99 m/s), while no significant difference was observed in SVs values. Patients with higher grades of tricuspid regurgitation (TR) had significantly different values of PVPI (P=0.010) and sonoelastographic parameters (P<0.001 for LVs and P=0.004 for SVs) compared to those with less severe TR. Tricuspid annular plane systolic excursion values were the only investigated parameter found to be associated with survival (hazard ratio, 0.814; 95% confidence interval, 0.694 to 0.954; P=0.011). Conclusion: Our results demonstrated a direct association between cardiac congestion (i.e., the severity of TR) and liver stiffness, which should be kept in mind during the assessment of fibrosis in patients with PAH.
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HCV, Acute, LT : IL28B Gene Polymorphisms in Myanmar Patients with Chronic HCV Infection
( Mk Kyaw ),( Km Win ),( Nmkt Hlaing ),( Amm Kyaw ),( Ah Bwa ),( St Aung ),( Lt Lwin ),( Wt Lwin ),( S Hlaing ),( Sl Htet ),( Zm Aung ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Introduction: IL28B gene is a gene which is located on the human chromosome 19. Recently, it was discovered that favourable IL28B gene polymorphisms is associated with the viral clearance and achievement of sustained virological response (SVR) in the treatment of chronic hepatitis C infection. Therefore, studies of IL28B gene polymorphisms can help us to predict whether the treatment of chronic hepatitis C will attain SVR or not. The prediction of SVR by IL28B will be useful in genotype 1 patients because our real life experience showed that SVR rate in Myanmar patients with G 1 is around 80 % (Less than 50 % in Western countries with unfavourable gene polymorphisms in majority of the cases) and that may be due to favourable IL28B gene polymorphisms in Myanmar patients with chronic HCV infection. Up to now there is no data on the prevalence of different IL28B gene polymorphisms in Myanmar patients. Conduct of the Study Study Population: This study consists of 171 patients from Yangon GI and Liver Centre and Mandalay Specialists Centre. Blood samples were sent to National University Hospital, Singapore, and two types of IL28B gene polymorphisms were determined viz. rs12979860 (CC favourable genotype) and rs8099917 (TT favorable genotype). Results: Out of 171 patients who participated, the results showed that about 86% of all genotypes (i.e.149 patients) are of CC/TT type. Among G1 patients 36 out of 41 patients (89%) are favourable genotype CC/TT. Conclusion: As CC/TT is favorable genotype for SVR, it is concluded that Myanmar patients with G1 unlike Western patients with G1, will have a high SVR rate of more than 80% with the current standard of care (SOC). Therefore, Directly Acting Antivirals (DAA) may not be necessary for the naive Myanmar patients with G1 chronic HCV patients. Recommendation: It is recommended to continue the study of SVR rates among different IL28B genotypes in Myanmar patients with chronic HCV patients who are receiving antiviral therapy.
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