Prevalence of arterial hypertension in liver cirrhosis and correlation with the severity of liver disease

Background and aim: Metabolic diseases and hypertension have increased dramatically in recent years, so the prevalence of hypertension in patients with cirrhosis is expected to increase. The aim of the study was to estimate the prevalence of hypertension in patients with liver cirrhosis and to determine its association with the severity of the liver disease. Patients and methods: This was a descriptive, cross-sectional, analytical study conducted at the Tropical Medicine and Infectious Diseases Department, Tanta University Hospital, Egypt. A total of 2051 patients with liver cirrhosis of various etiology were screened for participation in this study.  2014 patients were enrolled. They underwent blood pressure evaluation, blood tests and abdominal ultrasonography. Patients were classified into hypertensive and non-hypertensive groups. Results: The prevalence of arterial hypertension in patients with liver cirrhosis was 30.8%. As regards Child-Pugh class, hypertensive patients in class A were significantly increased (72.9 versus 48.7% respectively) while patients in class B and C were significantly decreased when compared with non- hypertensive patients (25.5,1.6 versus 33.29,17.93% respectively) (P <0.001). Conclusions: The prevalence of arterial hypertension in Egyptian cirrhotic patients is 30.7%, lower than that of the general population. Arterial hypertension is inversely associated with the severity of liver disease

Hypervascular Nodules and Stiffer Liver are Associated with Recurrence after Microwave Ablation in Patients with Hepatocellular Carcinoma: A Double-Center Analysis

Background and Aims The aim of this study was to detect the most important risk factors for recurrence after microwave ablation (MWA) of hepatocellular carcinoma (HCC). Methods A total of 92 patients with 110 HCC focal lesions (FLs) underwent MWA therapy. All the patients underwent triphasic CT before and after 1 and 3 months of MWA therapy. Complete ablation and recurrence rates were recorded, and the risk factors associated with recurrence were analyzed. Results Regarding the 110 HCC FLs that were detected pre-MWA, adequate ablation was recorded post-MWA procedure in 88 FLs (80%) and incomplete ablation in 22 FLs (showed residual contrast enhancement). However, there were newly detected lesions (17 FLs). The rate of recurrence was significantly higher in patients with multiple larger (> 4 cm) sized and hypervascular nodules. Diabetics were significantly associated with a higher recurrence rate of HCC. The rate of recurrence was significantly higher in patients with baseline level of serum alfa-fetoprotein (AFP) ≥200 ng/mL. Stiffer liver> 25 kPa had higher incidence for recurrence after ablation. Conclusion Meticulous follow-up is mandatory in diabetic patients, patients with AFP > 200 ng/dL starting value, hypervascular large hepatic FL, and in stiffer liver> 25 kPa, as these patients have higher incidence for recurrence after ablation