Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6050-6059
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6050
Influences of etiology and endoscopic appearance on the long-term outcomes of gastric antral vascular ectasia
Hyo Jin Kwon, Si Hyung Lee, Joon Hyun Cho
Hyo Jin Kwon, Si Hyung Lee, Joon Hyun Cho, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
Author contributions: Cho JH and Lee SH designed the study; Kwon HJ and Cho JH performed the research; Kwon HJ and Cho JH analyzed the data; Cho JH wrote the paper; Lee SH and Cho JH revised the manuscript.
Supported by the 2020 Yeungnam University Research Grant.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Yeungnam University Hospital (IRB No. 2021-10-044).
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joon Hyun Cho, MD, PhD, Associate Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea.ygowgo96@hanmail.net
Received: December 18, 2021
Peer-review started: December 18, 2021
First decision: January 23, 2022
Revised: January 31, 2022
Accepted: April 24, 2022
Article in press: April 24, 2022
Published online: June 26, 2022
ARTICLE HIGHLIGHTS
Research background

Gastric antral vascular ectasia (GAVE) is associated with diverse medical conditions such as liver cirrhosis, chronic kidney disease, and autoimmune disease. This heterogeneity of underlying disorders suggests that the pathogenesis of GAVE may not be uniform.

Research motivation

Many studies have sought to determine whether clinical features differ in GAVE with or without cirrhosis. However, few have examined the effects of its etiologies and endoscopic patterns on long-term clinical courses or outcomes, especially in Asians.

Research objectives

To determine whether etiologies and endoscopic patterns are related to the clinical features and course of GAVE.

Research methods

A retrospective analysis of 23 consecutive patients diagnosed with GAVE from January 2006 to December 2020 was conducted. Patients were allocated to cirrhosis (16 patients) and non-cirrhosis groups (7 patients), and GAVE subtypes, as determined by endoscopy, were categorized as punctate (a diffuse, honeycomb-like appearance, 17 patients) or striped (a linear, watermelon-like appearance, 6 patients).

Research results

Punctate-type GAVE was strongly associated with liver cirrhosis, whereas striped-type GAVE was strongly associated with non-cirrhotic underlying disease. Additionally, GAVE patients without cirrhosis experienced overt bleeding more often and required APC treatment more frequently than those with cirrhosis. However, mean numbers of admissions due to GAVE bleeding and of APC sessions for overt bleeding were similar in the cirrhosis and non-cirrhosis groups and in the striped and punctate groups.

Research conclusions

GAVE etiologies may result in different clinical manifestations, especially as regards bleeding. However, etiologies and endoscopic patterns were not found to influence long-term clinical courses or treatment outcomes in cases of overt bleeding.

Research perspectives

This study is one of the few to analyze the effects of GAVE etiologies and endoscopic patterns on long-term clinical courses and outcomes. Additional studies are needed to identify those factors that play key roles in the development and clinical course of GAVE and to clarify its pathophysiologic mechanism.