Clinical Research Directory

Inclusion Criteria: * Patients ≥ 18 years * Suspected portal hypertension associated with cirrhosis (of any aetiology) as defined by: 1. Baveno VII criteria : Liver stiffness ≥ 25 kPa Or Liver stiffness between 20 and 25 kPa and platelets \< 150 G/L Or Liver stiffness between 15 and 20 kPa and platelets \< 110 G/L Or Liver stiffness \> 20 kPa and/or platelets \< 150 G/L in patients with cirrhosis due to NASH Or Oesophageal varices with high risk of bleeding : Size \> 5 mm (stage 2 or 3) Or Size ≤ 5 mm and red spots Or Size ≤ 5 mm and Child-Pugh score C 2. and/or the presence of a radiological sign of portal hypertension : Portosystemic shunts: rectal varices, splenorenal shunts, repermeabilization of the umbilical vein. 3. and/or splenic elasticity \> 50 kPa. * Patients naive to treatment with cardioselective beta blockers * Affiliated to french health insurance system Exclusion Criteria: * Absolute contraindications to beta blockers : * hypersensitivity to the active substance (carvedilol) or to any of the excipients listed in section 6.1 of the summary of product characteristics * patients with severe decompensated heart failure, with signs of fluid overload (oedema, ascites, pulmonary stasis rales), and/or requiring treatment with a positive inotrope or venous vasodilator * second and third-degree atrioventricular blocks (unless presence of a permanent pacemaker) * severe bradycardia (≤ 50 bpm) * cardiac sinus disease (including sino-auricular block) * severe hypotension (systolic pressure \< 85 mm Hg) * cardiogenic shock * severe asthma, severe chronic obstructive pulmonary disease, history of severe bronchospasm * history of anaphylactic reaction * Raynaud's phenomenon * peripheral circulatory disorder: severe obliterative arterial disease of the lower limbs * association with cimetidine * association with class I antiarrhythmics except lidocaine * pulmonary arterial hypertension * Presence of severe acute alcoholic hepatitis (Madrey score ≥ 32). * Current hepatic encephalopathy ≥ Grade 2. * Ongoing hepato-renal syndrome. * Profuse clinical ascites (only if it interferes with the feasibility of echo-endoscopy). * History of oesophageal varices rupture. * Hepatocellular carcinoma active or in remission for less than six months. * Active or resolved portal vein thrombosis for less than six months. * History of digestive surgery that does not allow the porto-systemic gradient to be measured using echo-endoscopy (gastrectomy, by-pass, etc.). * Patients taking antiaggregants (except acetylsalicylic acid) or anticoagulants for embologenic CA/FA. * Severe stage 4 chronic renal insufficiency or stage 5 end-stage renal insufficiency (clearance \< 30 mL/min). * Pregnant or breast-feeding women, or those planning to become pregnant\*. \*A pregnancy test will be carried out for women of childbearing potential, and the investigator will ensure that effective contraception is in place while Carvedilol is being taken and for 5 half-lives after stopping it. * Patients protected by law (under guardianship, curatorship or safeguard of justice) or deprived of their freedom. * Patients currently taking part in another clinical research protocol. * Patients who do not understand French language.