Hepatic Venous Pressure Gradient: To Measure or Not To Measure, That Is the Question

Sanyal, Arun J.

doi:10.1053/jhep.2000.20091

Cited by 17 publications

(7 citation statements)

References 10 publications

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“…Indeed, we found no differences in HVPG between patients with small and large oesophageal varices [5,8]. Thus, above the threshold of 12 mmHg, the HVPG is not a predictive factor of bleeding [21], and the lack of a clear-cut correlation between an HVPG of over 12 mmHg and the risk of bleeding indicates that other factors influence bleeding risk [22].…”

Section: Discussionmentioning

confidence: 67%

Hepatic venous pressure gradient determination in patients with hepatitis C virus-related and alcoholic cirrhosis

Bellis¹,

Castellacci²,

Montagnese³

et al. 2003

European Journal of Gastroenterology & Hepatology

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Section: Discussionmentioning

confidence: 67%

Hepatic venous pressure gradient determination in patients with hepatitis C virus-related and alcoholic cirrhosis

Bellis¹,

Castellacci²,

Montagnese³

et al. 2003

European Journal of Gastroenterology & Hepatology

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“…HVPG plays a central role not only in diagnosis, but also for treatment monitoring of portal hypertension (8–12). Unfortunately, measurement of HVPG is invasive, typically performed by placement of a balloon catheter in the right hepatic vein, via the internal jugular vein, where the difference between the wedged venous pressure and systemic venous pressure is used to estimate HVPG (13–16).…”

mentioning

confidence: 99%

In vivo validation of 4D flow MRI for assessing the hemodynamics of portal hypertension

Roldán‐Alzate

Frydrychowicz

Niespodzany

et al. 2012

Magnetic Resonance Imaging

100

103

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Purpose to implement and validate in vivo radial 4D flow MRI for quantification of blood flow in the hepatic arterial, portal venous and splanchnic vasculature of healthy volunteers and patients with portal hypertension. Methods & Materials 17 patients with portal hypertension and 7 subjects with no liver disease were included in this HIPAA-compliant and IRB-approved study. Exams were conducted at 3T using a 32-channel body coil with large volumetric coverage and 1.4mm isotropic true spatial resolution. Using post-processing software, cut-planes orthogonal to vessels were used to quantify flow (L/min) in the hepatic and splanchnic vasculature. Results Flow quantification was successful in all cases. Portal vein and supra-celiac aorta flow demonstrated high variability among patients. Measurements were validated indirectly using internal consistency at three different locations within the portal vein (error=4.2±3.9%) and conservation of mass at the portal confluence (error=5.9±2.5%) and portal bifurcation (error=5.8±3.1%). Discussion This work demonstrates the feasibility of radial 4D flow MRI to quantify flow in the hepatic and splanchnic vasculature. Flow results agreed well with data reported in the literature, and conservation of mass provided indirect validation of flow quantification. Flow in patients with portal hypertensions demonstrated high variability with patterns and magnitude consistent with the hyperdynamic state that commonly occurs in portal hypertension.

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“…In clinical practice, HVPG measurement could have several applications [20][21][22][23], such as: y Evaluation of the risk of variceal haemorrhage.…”

Section: Ph Measurementsmentioning

confidence: 99%

The use of vasoconstrictors in patients with liver cirrhosis: how, when, why

Puoti¹

2012

CMI

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Portal hypertension (PH) is a severe complication of liver cirrhosis. Patients with PH run the risk of developing gastro-esophageal varices and massive gastrointestinal bleeding, ascites, hepatorenal syndrome, and hepatic encephalopathy. Portal blood flow in its turn increases because of enhanced production of vasodilators, increased eNOS activity and NO release, systemic and splanchnic vasodilation, hyperkinetic circulation, and hyposensitivity to vasoconstrictors. Thus, it is now widely recognized that this hyperkinetic (hyperdynamic) circulation that characterizes liver cirrhosis is the main cause of the complications of the disease. This review is aimed at addressing the role of vasoconstrictor treatment in patients suffering from complications of decompensated cirrhosis, offering practical suggestions for the management of this treatment at bedside. In particular, the management of terlipressin in patients with cirrhosis, its side effects and the efficacy of this vasoconstrictor will be examined.

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Hepatic Venous Pressure Gradient: To Measure or Not To Measure, That Is the Question

Cited by 17 publications

References 10 publications

Hepatic venous pressure gradient determination in patients with hepatitis C virus-related and alcoholic cirrhosis

Hepatic venous pressure gradient determination in patients with hepatitis C virus-related and alcoholic cirrhosis

In vivo validation of 4D flow MRI for assessing the hemodynamics of portal hypertension

The use of vasoconstrictors in patients with liver cirrhosis: how, when, why

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