Assessment and management of portal hypertension in patients with MASLD: advances and caveats.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-12 DOI:10.1080/17474124.2025.2530605

Diego Rojo, Alba Jiménez-Masip, Laura Pagès, Juan Bañares, Clara Sabiote, María Martínez-Gómez, Laia Aceituno, M Serra Cusidó, M Teresa Salcedo-Allende, Zyanya Calixto, Mònica Pons, Joan Genescà, Juan M Pericàs

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引用次数: 0

Abstract

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly gaining relevance both as a public health issue and a clinical challenge. The development of portal hypertension in MASLD challenges traditional paradigm that it arises only in the context of cirrhosis.

Areas covered: This review explores the understanding of portal hypertension in MASLD, addressing recent advances in pathophysiology, diagnosis, and potential therapeutic approaches. Particular attention is given to studies that highlight non-cirrhotic contributors to increased portal pressure. Pathogenic mechanisms, as well as advances in noninvasive diagnostic tools are discussed, focusing on their utility in identifying early hemodynamic changes and stratifying the risk of clinical complications. A comprehensive literature search was conducted using PubMed and major databases, including studies published up to April 2025.

Expert opinion: The future of MASLD management lies in early detection, improved noninvasive risk stratification, and personalized treatment strategies. Advances in technology and artificial intelligence will likely enhance diagnostic precision while ongoing research into molecular mechanisms and portal hypertension may enable earlier and effective therapeutic interventions.

查看原文本刊更多论文

门静脉高压在MASLD患者中的评估和管理：进展和警告。

摘要：代谢功能障碍相关的脂肪变性肝病（MASLD）作为公共卫生问题和临床挑战越来越重要。门静脉高压在MASLD的发展挑战了传统的范式，它只出现在肝硬化的背景下。涵盖领域：本综述探讨了对MASLD门静脉高压的理解，阐述了病理生理学、诊断和潜在治疗方法的最新进展。特别关注那些强调非肝硬化导致门静脉压力增加的研究。本文讨论了发病机制以及无创诊断工具的进展，重点讨论了它们在识别早期血流动力学变化和分层临床并发症风险方面的应用。使用Pubmed和主要数据库进行了全面的文献检索，包括截至2025年4月发表的研究。专家意见：MASLD管理的未来在于早期发现、改进的无创风险分层和个性化治疗策略。技术和人工智能的进步可能会提高诊断的准确性，而正在进行的对分子机制和门静脉高压的研究可能会使早期和有效的治疗干预成为可能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.