Use of Noninvasive Tests to Assess Clinically Significant Portal Hypertension and Response to Beta-Blockers.

Hepatic venous pressure gradient is the gold standard for determining the presence of clinically significant portal hypertension and response to nonselective beta-blocker therapy. Of late, noninvasive tests (NITs) using algorithms based on blood tests, measurement of liver and splenic stiffness and radiomics have been found to reliably reflect stages of liver fibrosis and presence of portal hypertension. There is limited, but emerging evidence that NITs could be useful in predicting response to treatment with beta-blockers. In this review, we discuss the present status of the NITs in monitoring response and predicting nonresponse to nonselective beta-blockers therapy in patients with cirrhosis and clinically significant portal hypertension. This update also focuses on the benefits of NITs as they could be used dynamically with ease over prolonged periods.