Hepatic venous pressure gradient correlates with advanced hepatic fibrosis: a retrospective review

Vincent, Jonathan K; Stark, Christopher M.; Shields, Joseph T; Bhave, Anant D.; Morris, Christopher S.

doi:10.1007/s00261-017-1171-y

Cited by 3 publications

(1 citation statement)

References 36 publications

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“…23 HVPG has also been shown to correlate with the histologic severity of liver fibrosis in patients with hepatitis B virus (HBV)-and hepatitis C virus (HCV)-related chronic hepatitis. 7,24,25 Several studies compare HVPG measurements before and after treatment in patients with chronic hepatitis C. In a study of 20 patients with advanced chronic HCV hepatitis, Rincon et al showed that there was a significant reduction in HVPG after induction of antiviral therapy. 26 Significant reductions in HVPG were also demonstrated in patients with HCV-related cirrhosis who achieved sustained viral response to treatment.…”

Section: Chronic Viral Hepatitismentioning

confidence: 99%

Measurement of Portal Pressure and its Application in the Clinical Setting

2017

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Portal hypertension is a severe, yet common sequela of patients with chronic liver disease and is responsible for many of the complications seen in this population. Measurement of the hepatic venous pressure gradient (HVPG) is the current gold standard technique for identifying and evaluating the severity of portal hypertension. Any increase in HVPG to ≥10 mm Hg is considered clinically significant portal hypertension. Above this threshold, complications of portal hypertension begin to manifest. In addition to assessing portal hypertension, various HVPG thresholds have been shown to have strong prognostic value for risk of complications and therapeutic failure, as well as survival in patients with chronic liver disease. These clinical applications include quantification of disease progression and regression in chronic viral hepatitis, acute alcoholic hepatitis, and hepatocellular carcinoma. Other applications include preoperative evaluation of liver resection and transplantation in patients with cirrhosis and hepatocellular carcinoma, assessment of response to therapy for portal hypertension, and identification of the need for transjugular intrahepatic portosystemic shunt (TIPS) revision.

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Section: Chronic Viral Hepatitismentioning

confidence: 99%

Measurement of Portal Pressure and its Application in the Clinical Setting

2017

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Hepatic venous pressure gradient evaluates the Scheuer stage of liver fibrosis by transjugular liver biopsy: a multicenter study

Zhang¹,

Wang²,

Xia³

et al. 2023

HPB

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Transjugular Liver Biopsy with Hemodynamic Evaluation: Correlation between Hepatic Venous Pressure Gradient and Histologic Diagnosis of Cirrhosis

Ferral

Fimmel

Sonnenberg

et al. 2021

JCIS

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Objectives: Measurement of hepatic vein pressures is the accepted gold standard for the evaluation of portal hypertension. This study was conducted to evaluate the correlation between hepatic vein pressure measurements and histologic findings from transjugular liver biopsies. The hypothesis was that higher hepatic venous pressure gradients would correlate with a histologic diagnosis of cirrhosis. Material and Methods: We identified all patients who underwent transjugular liver biopsies at our institution between January 2015 and December 2019. Of these, 178 patients who had undergone hemodynamic evaluations during the biopsy procedure were included in the study. Demographic information and laboratory data were extracted from the patients’ electronic medical records. The hepatic vein pressure gradient (HVPG) was determined by subtracting the free hepatic venous pressure from the wedged hepatic venous pressure (WHVP), and the portosystemic gradient (PSG) was determined by subtracting the right atrial pressure from the WHVP. HVPG and PSG were compared by linear regression analysis and by calculating their receiver operating characteristics (ROC). Results: HVPG and PSG measurements were significantly associated with cirrhosis, with area under the ROC curve of 0.79 and 0.78, respectively. At the optimal cutoff of 9 mmHg, sensitivity and specificity for HVPG were 71% and 83% for HVPG and 67 % and 81% for PSG, respectively. No statistical difference was observed between the two measurements. Conclusion: A transhepatic venous pressure gradient above a cutoff of 9 mmHg is predictive of histologic cirrhosis, regardless of whether it is expressed as HVPG or PSG, with acceptable to excellent performance characteristics.

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Hepatic venous pressure gradient correlates with advanced hepatic fibrosis: a retrospective review

Abstract: HVPG correlates with stage 4 (advanced) hepatic fibrosis.

Cited by 3 publications

References 36 publications

Measurement of Portal Pressure and its Application in the Clinical Setting

Measurement of Portal Pressure and its Application in the Clinical Setting

Hepatic venous pressure gradient evaluates the Scheuer stage of liver fibrosis by transjugular liver biopsy: a multicenter study

Transjugular Liver Biopsy with Hemodynamic Evaluation: Correlation between Hepatic Venous Pressure Gradient and Histologic Diagnosis of Cirrhosis

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