Novel Approaches and Disease Modifiers to Alter the Course of Cirrhotic Portal Hypertension

Abstract

This chapter elaborates on novel approaches and potential and promising non-etiological disease modifiers to alter the course of cirrhotic Portal Hypertension (PHT) through a focus on regression and progression of cirrhosis as well as on the active dynamic component of intrahepatic resistance associated with PHT and multi-targeted interventions directed against bacterial translocation, hepatic and systemic inflammation as these latter have been identified as the fundamental co-drivers towards decompensation. Therapies such as statins, rifaximin, albumin, anticoagulation. In addition, we also elaborate on the novel diagnostic avenue of “endo-hepatology” which refers to a novel concept integrating different Endoscopic Ultrasound (EUS)-applications with regard to the assessment of liver diseases and portal hypertension. In particular, the current status of EUS-guided portal pressure measurement is critically reviewed and positioned against the golden standard of HVPG. In this chapter, we will give an aggregated overview of potential novel approaches and non-etiological disease modifiers as well as not yet discussed potential future novel diagnostic platforms to assess portal hypertension.