1.Background Handgrip strength , a core indicator of muscle function, has been confirmed to be significantly associated with the clinical prognosis of patients with liver cirrhosis. However, no studies have explored its correlation with portal venous hemodynamics. 2. Objective The purpose of the study is to examine the effects of Handgrip strength on portal vein and left gastric vein pressure, blood flow velocity and direction in patients with liver cirrhosis. 3\. Method: observational study. Detection Timing: Doppler ultrasound was employed to determine the portal flow velocity and direction at baseline and during the handgrip strength test in cirrhotic patients with a history of variceal bleeding. Three days later, prior to TIPS placement, the pressures in the portal pressure and gastric vein pressure were measured both before and after handgrip strength. Furthermore, carvedilol and vasoactive drugs were discontinued three days before the study commenced. 4. Elaboration of the Research Hypothesis 4.1. Core Hypothesis The handgrip strength level in patients with liver cirrhosis is correlated with portal venous system hemodynamic indices. Specifically, enhanced handgrip strength may affect portal hypertension and the hemodynamics of varicose veins by improving systemic muscle function or circulatory status. 4.2. Speculation on potential mechanisms Association between muscle function and circulation: As a representative of systemic muscle function, increased handgrip strength may reflect an increase in cardiac output or changes in splanchnic vascular resistance, thereby influencing portal venous hemodynamics.
Study Type
OBSERVATIONAL
Enrollment
64
Jamar Hand Dynamometer, from Illinois, USA. Maximum handgrip strength was measured three times, with each measurement lasting 3 seconds and a 1-minute interval between tests
The First Affiliated Hospital of Henan University of Science and Technology
Luoyang, Henan, China
Shanxi Provincial People's Hospital
Taiyuan, Shanxi, China
portal pressure
Prior to TIPS, the pressure monitoring catheter was connected to the pressure-measuring device. Subsequently, the pressures in both the portal vein and left gastric vein were measured simultaneously at baseline and during the handgrip strength test.
Time frame: through study completion, an average of 5 minutes
left gastric vein pressure
Prior to TIPS, the pressure monitoring catheter was connected to the pressure-measuring device. Subsequently, the pressures in both the portal vein and left gastric vein were measured simultaneously at baseline and during the handgrip strength test.
Time frame: through study completion, an average of 5 minutes
portal flow velocity
Time frame: At least 72 hours after the baseline handgrip strength and during the handgrip strength phase, measurements were conducted at intervals of 15 seconds, 30 seconds, 45 seconds, and 60 seconds after the release of strength related to the handgrip Strength
Portal vein blood flow direction
Time frame: At least 72 hours after the baseline handgrip strength and during the handgrip strength phase, measurements were conducted at intervals of 15 seconds, 30 seconds, 45 seconds, and 60 seconds after the release of strength related to the handgrip Strength
Serum albumin (g / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
alanine aminotransferase(IU / L)
Pre-TIPS baseline characteristics, date (n=32)
Time frame: Baseline
aspartate aminotransferase (IU / L)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Total bilirubin (µmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Prothrombin time (second)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Fasting blood glucose (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
triglyceride (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Total cholesterol (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Serum creatinine (µmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Serum potassium (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Serum sodium (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Serum chloride (mmol / l)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
Platelet count (× 109 / mm3)
Pre-TIPS baseline characteristics ,date (n=32)
Time frame: Baseline
height
Time frame: Baseline
weight
Time frame: Baseline
Model for end-stage liver disease score
Model for end-stage liver disease score: 6-40, the higher scores mean a worse outcome.
Time frame: Baseline
Child-Pugh score
Child-Pugh score: 5-15, the higher scores mean a worse outcome
Time frame: Baseline
Esophageal varices before endoscopic treatment
The diagnosis of esophageal varices and variceal bleeding in patients is confirmed by upper gastrointestinal endoscopy.
Time frame: Baseline
Collateral vessels before TIPS placement
Vascular angiography was performed prior to TIPS placement to diagnose collateral circulation. date (n=32)
Time frame: Baseline
Ascites
Prior to TIPS, ascites was evaluated by ultrasound in 32 patients with liver cirrhosis.
Time frame: Baseline
Prior overt hepatic encephalopathy
Time frame: Baseline
Etiology of cirrhosis
Time frame: Baseline
Age
Time frame: Baseline
Sex
Time frame: Baseline
Handgrip Strength
Time frame: Baseline
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