B-SMaRT study
Research type
Research Study
Full title
Beta-blocker Stratification using quantitative MRI techniques to assess portal pressure and Response to Treatment in patients with portal hypertension
IRAS ID
202113
Contact name
Robert A D Scott
Contact email
Sponsor organisation
The University of Nottingham
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Most people with liver disease do not have symptoms. Over time they develop ‘cirrhosis’ - severe liver scarring. Cirrhosis causes increased pressure within the liver leading to the development of varicose veins in the gullet known as ‘varices’. Varices bleed easily, leading to emergency situations that can be life threatening. However, if the increased pressure within the liver (portal pressure) is detected early, then treatment can prevent variceal bleeding.
Currently the only existing test to measure portal pressure is to pass a pressure sensor through a vein in the neck, down into the liver, called the hepatic venous pressure gradient (HVPG) measurement. It is disliked by patients, expensive and not widely available in the NHS. Hence, patients with cirrhosis need to have regular camera tests (endoscopies) to look for varices.
If varices are found they can be treated with tablets to lower the pressure (beta-blockers). Most patients are given beta-blockers and monitored closely to see if they work. Beta-blockers can cause side effects (e.g. fainting) that are unpleasant enough to make 1/3 patients stop taking them; also Beta-blockers only reduce the portal pressure in 50% patients.
Magnetic Resonance Imaging (MRI) can be used to measure portal pressure. This study will investigate whether MRI can accurately detect changes in portal pressure after treatment with beta-blockers in order to identify which patients are responding to treatment.
Cirrhosis patients on the beta-blocker Carvedilol will be invited to take part in this study and as a result of this will have their portal pressures measured by both HVPG and MRI.
We hope this study will tell us whether MRI can be used instead HVGP in the future and prevent the need for more invasive tests.REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
16/EM/0323
Date of REC Opinion
1 Sep 2016
REC opinion
Further Information Favourable Opinion