Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2025; 31(9): 103068
Published online Mar 7, 2025. doi: 10.3748/wjg.v31.i9.103068
Multicenter analysis on the correlation between the anatomical characteristics of hepatic veins and hepatic venous wedge pressure
Qiu-Xia Ye, Ming-Ming Meng, Yi-Fan Wu, Cheng-Bin Dong, Yu Zhang, Bo-Wen Liu, Yi-Fan Lv, Shao-Li You, Sa Lv, Hui-Guo Ding, Ying Han, Yong-Ping Yang, Bing Zhu, Fu-Quan Liu
Qiu-Xia Ye, Ming-Ming Meng, Yi-Fan Wu, Cheng-Bin Dong, Yu Zhang, Bo-Wen Liu, Yi-Fan Lv, Fu-Quan Liu, Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Shao-Li You, Sa Lv, Yong-Ping Yang, Bing Zhu, Liver Vascular Disease Diagnosis and Treatment Center, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
Hui-Guo Ding, Ying Han, Department of Gastroenterology and Hepatology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China
Co-corresponding authors: Bing Zhu and Fu-Quan Liu.
Author contributions: Ye QX, Zhu B and Liu FQ took the lead in conceiving and mapping out the research framework. Wu YF, Dong CB, Zhang Y, You SL, Lv S, Liu BW, Yang YP, Han Y and Ding HG carried out the operations, meticulously screened patients based on specific criteria, and systematically acquired comprehensive clinical data, which served as the raw materials for in-depth analysis. Meng MM, in cooperation with Wu YF and Dong CB, focused on the collection of blood specimens and undertook the complex task of laboratory analysis. Zhang Y, You SL, Lv S and Lv YF employed advanced statistical methods and analytical tools to extract meaningful insights and patterns from the vast amount of collected data. Liu BW, Yang YP, Han Y, Lv YF and Ding HG actively participated in the formal analysis and in-depth investigation. Ye QX, Zhu B and Liu FQ took on the responsibility of drafting the initial manuscript. All the authors meticulously reviewed and gave their approval to the final manuscript, ensuring its quality and integrity. Both Zhu B and Liu FQ played pivotal and irreplaceable roles throughout the research process. As co-corresponding authors, they brought their unique perspectives and expertise to create a robust and innovative design. In data interpretation, they analyzed results carefully to extract scientific meaning. For manuscript preparation, Liu FQ actively applied for and got project funds, led the project's conceptualization, design and supervision, searched literature, revised drafts and submitted them. Meanwhile, Zhu B focused on re-analyzing data for robustness, conducted literature search and prepared the current manuscript version. This collaboration between Zhu B and Liu FQ is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by Capital Medical University Affiliated Beijing Shijitan Hospital Talent Development Program during the 14th Five-Year Plan, No. 2023 LJRCLFQ.
Institutional review board statement: The study was reviewed and approved by Institutional Review Boards of Beijing Shijitan Hospital (Approval No. 2018/01), the Fifth Medical Center of Chinese PLA General Hospital (Approval No. KY-2023-12-82-1), Beijing You’an Hospital (Approval No. LL-2023-042-K).
Informed consent statement: Informed consent: Since this research project was conducted on the basis of patients' routine treatment surgeries, without any additional procedures and without causing harm to the patients' bodies, we adopted the waiver of informed consent in the clinical setting.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: 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: Fu-Quan Liu, MD, Professor, Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing 100038, China. lfuquan@aliyun.com
Received: November 13, 2024
Revised: December 17, 2024
Accepted: January 20, 2025
Published online: March 7, 2025
Processing time: 97 Days and 1.4 Hours
Abstract
BACKGROUND

Wedged hepatic venous pressure (WHVP) is a crucial variable for accurately assessing the hepatic venous pressure gradient (HVPG) and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension (PH).

AIM

To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure (PVP).

METHODS

This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024. Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs. All patients' angiographic images were collected for analysis. The associations between WHVP and PVP in each group were analyzed via linear regression analysis, and a predictive model was established.

RESULTS

The 877 patients had a mean age of 52.6 ± 13.0 years, with 582 males and 295 females. Patients were categorized into four groups on the basis of their anatomical structure. All groups showed strong correlations between WHVP and PVP. The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884 (P < 0.05); in the hepatic right vein-accessory hepatic venous angiography group, it was 0.721 (P < 0.05); in the hepatic right vein-middle hepatic venous angiography group, it was 0.344 (P < 0.05); and in the hepatic right vein-nonangiography group, it was 0.293 (P < 0.05).

CONCLUSION

The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP. Based on the different anatomical classifications of hepatic veins, WHVP can be used to estimate PVP, improving the accuracy of PVP prediction.

Keywords: Wedged hepatic venous pressure; Portal venous pressure; Portal hypertension; Collateral branches of the hepatic vein; Transjugular intrahepatic portosystemic shunt

Core Tip: This multicenter study explored the relationship between the wedged hepatic venous pressure (WHVP) and portal venous pressure (PVP) in patients with portal hypertension patients. By analyzing anatomical characteristics through hepatic venous angiography, significant correlations were identified. An innovative finding revealed that WHVP, based on the anatomical classification of the hepatic vein, can be used to effectively estimate PVP, enhancing predictive accuracy. The presence and classification of hepatic venous collaterals play pivotal roles in this association, offering a promising approach for precise PVP prediction and improving patient prognosis in the management of portal hypertension.