Hepatology Research最新文献

{"title":"Successful Retreatment of Glecaprevir-Pibrentasvir for Hepatitis C Virus Genotype 2a Infection in Patient Whose Cirrhosis Improved From Decompensation to Compensation After Sofosbuvir-Velpatasvir Therapy.","authors":"Tatsuo Kanda, Ryota Masuzaki, Naoki Matsumoto, Reina Sasaki-Tanaka, Hirofumi Kogure","doi":"10.1111/hepr.70046","DOIUrl":"https://doi.org/10.1111/hepr.70046","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibulin Family Members: New Players in Liver Fibrosis and Potential Biomarkers in Chronic Liver Diseases.","authors":"Fidaa Bouezzedine, Célia Thomas, Nathalie Théret","doi":"10.1111/hepr.70032","DOIUrl":"https://doi.org/10.1111/hepr.70032","url":null,"abstract":"<p><p>Chronic liver diseases (CLD) arising from various etiologies including viral hepatitis, excessive alcohol intake, alcoholic associated liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD), are associated with persistent hepatic injury ultimately resulting in fibrosis. Liver fibrosis is characterized by the excessive accumulation of extracellular matrix (ECM). This pathological ECM deposition increases tissue stiffness, disrupts normal tissue architecture and impairs liver functions leading to cirrhosis which constitutes a major risk factor for the onset of hepatocellular carcinoma (HCC). The characteristics of the ECM in liver fibrosis have been extensively investigated, particularly with the use of recent proteomic approaches that provide a large overview of ECM changes during disease progression. Alongside large collagen fiber molecules, established as a hallmark of fibrotic tissues, numerous other matrix components are significantly altered. These include the fibulin family. These glycoproteins are distributed across various tissues and involved in numerous physiological processes including embryonic development and tissue repair. They are implicated in a range of pathological processes such as hypertrophic cardiomyopathy, chronic fibrotic disorders, and cancer. In healthy a liver, low levels of fibulins can be detected; however, the expression of a number of fibulin family members is markedly induced during the progression of fibrosis. Beyond their role in the organization and structure integrity of elastic fibers, their contribution to the pathogenesis of liver fibrosis and HCC remains poorly understood. The present review provides an up-to-date overview of the literature on fibulins in the context of chronic liver diseases with particular insights from new omics meta-analyses.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty Is an Independent Predictor of Mortality in Japanese Patients With Chronic Liver Disease: A Multicenter Retrospective Cohort Study.","authors":"Shinji Unome, Mikita Oi, Yuki Utakata, Takao Miwa, Masashi Aiba, Tatsunori Hanai, Makoto Shiraki, Yasuhiro Kawashima, Naoki Katsumura, Masahito Shimizu","doi":"10.1111/hepr.70042","DOIUrl":"https://doi.org/10.1111/hepr.70042","url":null,"abstract":"<p><strong>Aim: </strong>Frailty is emerging as a prognostic factor in chronic liver disease (CLD). However, its clinical impact remains underexplored, particularly in Japan. This study aimed to evaluate the prognostic significance of frailty in Japanese patients with CLD. In addition, the prevalence and clinical characteristics of frailty in this population were assessed.</p><p><strong>Methods: </strong>The present multicenter retrospective study included patients with CLD who were admitted to three institutions in Japan. Frailty was diagnosed based on a Clinical Frailty Scale score of > 4. Factors associated with prognosis and frailty were evaluated using Cox proportional hazards regression and logistic regression models, respectively.</p><p><strong>Results: </strong>Of 715 patients (median [interquartile range] age, 67 [56-74] years; 354 [49.5%] male; 227 [38.7%] with viral hepatitis), frailty was identified in 137 (19.2%). During the median follow-up of 2.9 years, 221 patients (28%) died. Patients with frailty had significantly shorter survival than those without frailty (median 2.4 vs. 10.6 years, p < 0.001). Multivariable Cox regression analysis showed that frailty was an independent adverse factor for mortality (hazard ratio, 1.75; 95% confidence interval, 1.25-2.45; p = 0.001) in patients with CLD. Regarding determinants of frailty, multivariable logistic regression analysis showed that older age, hepatic encephalopathy, hypoalbuminemia, thrombocytopenia, and prolonged international normalized ratio were associated with frailty.</p><p><strong>Conclusions: </strong>Frailty is prevalent in patients with CLD and independently predicts poor survival. Given its prognostic significance, frailty assessment should be incorporated for risk stratification, early intervention, and outcome improvement in patients with CLD.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Growth Differentiation Factor 15 Can Be a Novel Biomarker to Predict the Prognosis of Patients With Hepatitis C Virus Cirrhosis After Virus Elimination.","authors":"Yuta Myojin, Hayato Hikita, Yuki Tahata, Kenji Fukumoto, Seiya Kato, Yoichi Sasaki, Shusuke Kumazaki, Atsunori Tsuchiya, Masaru Enomoto, Daiki Miki, Hiroshi Yatsuhashi, Hidekatsu Kuroda, Yoshihito Uchida, Hitoshi Yoshiji, Taro Yamashita, Seiichi Mawatari, Nobuharu Tamaki, Hisamitsu Miyaaki, Yasuhiro Asahina, Goki Suda, Kentaro Matsuura, Yasunari Nakamoto, Yoichi Hiasa, Taro Takami, Kumiko Shirai, Kazuki Maesaka, Kazuhiro Murai, Yuki Makino, Yoshinobu Saito, Takahiro Kodama, Tomohide Tatsumi, Tetsuo Takehara","doi":"10.1111/hepr.70041","DOIUrl":"https://doi.org/10.1111/hepr.70041","url":null,"abstract":"<p><strong>Background and aims: </strong>Although direct-acting antivirals (DAAs) achieve high sustained virologic response (SVR) rates, the long-term outcomes of patients with hepatitis C virus (HCV)-related cirrhosis remain variable. Growth differentiation factor 15 (GDF15), a stress-induced cytokine, has emerged as a potential biomarker for liver disease progression. This study aimed to evaluate the prognostic value of serum GDF15 levels in predicting hepatocellular carcinoma (HCC), hepatic decompensation, and mortality in patients with HCV-related cirrhosis.</p><p><strong>Methods: </strong>We retrospectively analyzed 196 patients with HCV-related cirrhosis who achieved SVR at 18 Japanese institutions. Serum GDF15 levels were measured at baseline (BL) and 24 weeks posttreatment (p24w). A previously validated cutoff of 1.75 ng/mL was applied. The clinical outcomes included HCC occurrence, hepatic decompensation, and all-cause mortality.</p><p><strong>Results: </strong>During a median follow-up of 46.2 months, 75 patients developed HCC, 28 experienced hepatic decompensation, and 25 died. Hepatic decompensation occurred significantly less frequently in the BL GDF15-low group. Importantly, no deaths occurred in the GDF15-low group, whereas the 5-year survival rate in the GDF15-high group was 71.7%. Similar trends were observed for GDF15 levels at p24w. In the overall cohort, GDF15 was not significantly associated with incident HCC; among HCC-naïve patients, a nonsignificant trend toward lower 3-year HCC incidence was observed in the GDF15-low group.</p><p><strong>Conclusions: </strong>Serum GDF15 is a promising prognostic biomarker for post-SVR outcomes in patients with HCV-related cirrhosis. Its ability to predict decompensation and mortality through a validated cutoff supports its use for risk stratification and long-term management in patients with chronic liver disease.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FGFR2 Fusions or Rearrangements in Young Intrahepatic and Perihilar Cholangiocarcinoma Patients: Key Genetic Insights From a Pan-Asian Study.","authors":"Yuta Maruki, Yasushi Yatabe, Chiharu Mizoguchi, Kathleen Yasmin de Almeida, Aumkhae Sookprasert, Charuwan Akewanlop, Ming-Huang Chen, Ekaphop Sirachainan, Dao Van Tu, Rozita Abdul Malik, Chaiyut Charoentum, Hwoei Fen Soo Hoo, Suhana Yusak, Tsung-Hao Liu, Rangasamy Ramachandran, Patrapim Sunpaweravong, Pei Jye Voon, Najihah Abu Bakar, Junki Mizusawa, Hitomi Sumiyoshi Okuma, Kenichi Nakamura, Chigusa Morizane, Takuji Okusaka","doi":"10.1111/hepr.70031","DOIUrl":"https://doi.org/10.1111/hepr.70031","url":null,"abstract":"<p><strong>Aim: </strong>Biliary tract cancers, including intrahepatic cholangiocarcinoma (ICC), are aggressive with limited treatment options and poor prognosis. Recent trials (TOPAZ-1, Keynote-966) showed improved survival with ICIs plus gemcitabine and cisplatin. Targeted therapies, including FGFR inhibitors, are promising for cholangiocarcinoma patients with FGFR2 gene fusions or rearrangements, although few reports exist on FGFR2 positivity and clinical data in Asia. This study aims to address this gap by evaluating FGFR2 fusions or rearrangements in intrahepatic and perihilar cholangiocarcinoma patients across Asia, providing insights into their clinical significance and potential therapeutic implications.</p><p><strong>Methods: </strong>This multicenter study evaluated the frequency of FGFR2 rearrangements and fusion genes in ICC and perihilar cholangiocarcinoma across Asia (Thailand, Malaysia, Vietnam, and Taiwan) using fluorescence in situ hybridization (FISH) and comprehensive genomic profiling with the Todai OncoPanel2 (TOP2).</p><p><strong>Results: </strong>Of 113 patients, 102 were eligible; FGFR2 rearrangements/fusions were found in 3.9% (4 cases) by FISH, all of which were also confirmed by the TOP2 panel, consistent with the Japanese PRELUDE study. Younger age was significantly associated with FGFR2 positivity (34.5 ± 3.17 vs. 62.69 ± 1.04; p = 0.0003), whereas no correlation was observed with hepatitis infection, alcohol use, or smoking history. Genomic profiling identified frequent mutations in TP53, KRAS, and ARID1A with notable regional variability. Patients treated with ICIs showed significantly longer progression-free survival compared to other therapies: ICI + cytotoxic (348 days, 95% CI: 0-897), platinum-based + GEM (240 days, 95% CI: 197-282), and other treatments (168 days, 95% CI: 11-325; p = 0.017).</p><p><strong>Conclusion: </strong>The FGFR2 positivity rate in Asia is slightly lower but consistent with Japanese reports and is more common in younger patients with ICC. Distinct genetic alterations may characterize Asian populations.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Liver Fibrosis and Cause-Specific Mortality in Japanese Patients With Biopsy-Confirmed Metabolic Dysfunction-Associated Steatotic Liver Disease: A Prospective Cohort Study / Liver Fibrosis and Mortality in Japanese MASLD.","authors":"Kyoko Sakai, Toshihide Shima, Hirohisa Oya, Takahiro Miura, Shohei Amioka, Takahiro Nonaka, Shinsaku Fujiishi, Keiichiro Okuda, Kei Terasaki, Kohei Fukumoto, Yasuhide Mitsumoto, Masayuki Mizuno, Takeshi Okanoue","doi":"10.1111/hepr.70034","DOIUrl":"https://doi.org/10.1111/hepr.70034","url":null,"abstract":"<p><strong>Background: </strong>This study examined mortality patterns and their association with liver fibrosis in Japanese patients with biopsy-confirmed metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>We analyzed 1104 MASLD-eligible individuals from the Suita SLD cohort (2004-2023). Mortality rates were assessed using Kaplan-Meier analysis and compared between patients with and without fibrosis (Stages 1-4 vs. 0) and between metabolic dysfunction-associated steatohepatitis (MASH) and non-MASH groups, adjusting for age and sex. Associations between fibrosis or inflammation levels and cause-specific mortality were also evaluated.</p><p><strong>Results: </strong>Of the initial 1109 patients, 1104 met the MASLD criteria. Among these patients (544 men, 560 women; mean age: 57.2 years; mean follow-up period: 6.9 years), 93 patients died, primarily from hepatocellular carcinoma (HCC) (n = 17), liver failure (n = 16), extrahepatic malignancies (n = 17), cardio-cerebrovascular diseases (n = 7), and other causes (n = 36). Fibrosis was associated with higher all-cause (11.4% vs. 3.6%) and liver-related mortality (4.8% vs. 0%, both p < 0.0001), but not with nonliver-related mortality after adjustment. All-cause mortality was higher in the MASH group (11.2% vs. 2.6%, p < 0.0001), with increased risk of both liver- and nonliver-related deaths (adjusted hazard ratios: liver-related = 1.34 × 10¹⁷, 95% CI: NE, nonliver-related = 2.20, 95% confidence interval [CI]: 1.07-4.53).</p><p><strong>Conclusion: </strong>HCC and extrahepatic malignancies were the leading causes of death in Japanese patients with MASLD. Liver fibrosis was a significant predictor of both all-cause and liver-related mortalities, but not nonliver-related mortality, highlighting its importance in follow-up strategies for MASLD. MASH may contribute to increased nonliver-related deaths. Further long-term studies are warranted.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lenvatinib Versus Atezolizumab Plus Bevacizumab as First-Line Treatment for Advanced Hepatocellular Carcinoma With a CRAFITY Score of 2: A Multi-Center Retrospective Study.","authors":"Masayuki Ueno, Haruhiko Takeda, Atsushi Takai, Makoto Umeda, Hiroki Morimura, Shunsuke Okuyama, Norihiro Nishijima, Satoru Iwamoto, Shigeharu Nakano, Shu Nagatomo, Takeshi Seta, Tomoyuki Goto, Atsuyuki Ikeda, Takahisa Kayahara, Shin'ichi Miyamoto, Shujiro Yazumi, Taro Ueo, Yoshito Uenoyama, Kazuyoshi Matsumura, Masako Mishima, Tadashi Inuzuka, Yuji Eso, Ken Takahashi, Hiroyuki Marusawa, Yukio Osaki, Etsuro Hatano, Hiroshi Seno","doi":"10.1111/hepr.70040","DOIUrl":"https://doi.org/10.1111/hepr.70040","url":null,"abstract":"<p><strong>Aim: </strong>Atezolizumab plus bevacizumab (Atezo+Bev) therapy is the preferred first-line treatment for advanced hepatocellular carcinoma (HCC). However, the efficacy of Atezo+Bev is limited in patients with a CRAFITY score of 2 (C-reactive protein ≥ 1 mg/dL and alpha-fetoprotein [AFP] ≥ 100 ng/mL). This study compared the efficacy and safety of lenvatinib and Atezo+Bev in these patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 774 patients treated with lenvatinib or Atezo+Bev as first-line treatment for advanced HCC between October 2020 and December 2023 across 11 hospitals in Japan. Among them, 90 patients (11.6%) had a CRAFITY score of 2. Progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and safety profiles were compared.</p><p><strong>Results: </strong>Baseline characteristics were similar, except tumor size and AFP levels, which were higher in the Atezo+Bev group. Median PFS was significantly longer in the lenvatinib group compared to the Atezo+Bev group (6.0 vs. 2.3 months; hazard ratio [HR]: 0.55, 95% confidence interval [CI]: 0.32-0.95]; p = 0.032). The median OS was not significantly different between the two groups (9.8 vs. 5.2 months; HR: 0.66, 95% CI: 0.41-1.08; p = 0.101). The DCR (62.0% vs. 30.0%; p = 0.003) and the occurrence of grade ≥ 3 treatment-related adverse events (46.0% vs. 20.0%; p = 0.014) were significantly higher in the lenvatinib group than in the Atezo+Bev group.</p><p><strong>Conclusion: </strong>Lenvatinib provided a significantly longer PFS than Atezo+Bev in patients with HCC and a baseline CRAFITY score of 2, whereas OS did not significantly differ between the two groups. These findings may serve as a cornerstone for developing biomarker-based strategies in first-line treatment selection for this patient population.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HCV Elimination Strategies for Maximum Effectiveness, Tailored to National and Regional Circumstances.","authors":"Ken Sato","doi":"10.1111/hepr.70038","DOIUrl":"https://doi.org/10.1111/hepr.70038","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Tirzepatide Treatment on Hepatic Biomarkers in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease and Type 2 Diabetes Mellitus.","authors":"Dilara Tekin Uzman, Gizem Dağcı","doi":"10.1111/hepr.70039","DOIUrl":"https://doi.org/10.1111/hepr.70039","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bradycardic Responses During Thermal Ablation for Hepatocellular Carcinoma: Impact of Procedural Pain Severity and Autonomic Imbalance.","authors":"Yasuyuki Komiyama, Masaru Muraoka, Tetsuya Iijima, Leona Osawa, Hitomi Takada, Yuichiro Suzuki, Mitsuaki Sato, Shinichi Takano, Shinya Maekawa, Atsunori Tsuchiya, Nobuyuki Enomoto","doi":"10.1111/hepr.70013","DOIUrl":"https://doi.org/10.1111/hepr.70013","url":null,"abstract":"<p><strong>Aim: </strong>Bradycardic responses frequently occur during radiofrequency ablation (RFA) and microwave ablation (MWA) for hepatocellular carcinoma (HCC), but the impact of procedural pain severity and patient-specific factors remains unclear. This study aimed to evaluate the incidence and risk factors for bradycardic responses, focusing on procedural pain and autonomic regulation.</p><p><strong>Methods: </strong>This retrospective study included 267 patients with solitary HCC who underwent RFA or MWA between 2019 and 2024. Bradycardic responses were defined as a ≥ 30% decrease in heart rate from baseline or < 50 bpm. Patients were categorized by procedural pain severity using patient-controlled analgesia (PCA) bolus administration. Risk factors for bradycardia were assessed by logistic regression.</p><p><strong>Results: </strong>Bradycardic responses occurred in 70 patients (26.2%). Severe procedural pain (odds ratio [OR], 2.26 and p = 0.007) and primary HCC (OR, 2.68 and p = 0.002) were independent risk factors. In patients without severe pain, absence of angiotensin II receptor blocker (ARB) use increased bradycardia risk (OR, 0.14 and p = 0.013). Most bradycardic events (61.4%) occurred within 3 min of ablation initiation.</p><p><strong>Conclusions: </strong>Bradycardic responses during RFA and MWA are common and linked to procedural pain severity and autonomic imbalance. Comprehensive management, including pain control, medication review, and addressing procedural anxiety through counseling or sedation, may reduce risks and enhance procedural safety.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}