Zhang D, Wang T, Yue ZD, Wang L, Fan ZH, Wu YF, Liu FQ. Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension. World J Gastrointest Surg 2023; 15(11): 2490-2499 [PMID: 38111777 DOI: 10.4240/wjgs.v15.i11.2490]
Corresponding Author of This Article
Fu-Quan Liu, MM, Chief Doctor, Doctor, Professor, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China. liufuquan@ccmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2490-2499 Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2490
Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension
Dan Zhang, Tao Wang, Zhen-Dong Yue, Lei Wang, Zhen-Hua Fan, Yi-Fan Wu, Fu-Quan Liu
Dan Zhang, Zhen-Dong Yue, Lei Wang, Zhen-Hua Fan, Yi-Fan Wu, Fu-Quan Liu, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Tao Wang, Department of Interventional Therapy, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264099, Shandong Province, China
Author contributions: Liu FQ designed the research; Wang T, Yue ZD, Wang L, Fan ZH and Wu YF performed the research; Zhang D analyzed the data and wrote the paper; Liu FQ reviewed and revised the manuscript; All authors have read and approved the final manuscript.
Supported bythe Capital Health Research and Development of Special, No. 2018-1-2081; National Natural Science Foundation of China, No. 81871461.
Institutional review board statement: The study was reviewed and approved by the Beijing Shijitan Hospital, Capital Medical University Institutional Review Board [2018(01)].
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at liufuquan@ccmu.edu.cn. Participants gave informed consent for data sharing.
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, MM, Chief Doctor, Doctor, Professor, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No.10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China. liufuquan@ccmu.edu.cn
Received: August 13, 2023 Peer-review started: August 13, 2023 First decision: September 20, 2023 Revised: October 3, 2023 Accepted: October 23, 2023 Article in press: October 23, 2023 Published online: November 27, 2023 Processing time: 105 Days and 20.3 Hours
ARTICLE HIGHLIGHTS
Research background
The hepatic venous pressure gradient (HVPG), rather than the portal venous pressure gradient (PPG), is regarded as the gold standard for diagnosing portal hypertension (PHT).
Research motivation
The relationship between HVPG and PPG is controversial and lacks substantial research to prove it.
Research objectives
This study aimed to classify the correlation between HVPG and PPG in patients with alcoholic cirrhosis and PHT.
Research methods
This retrospective analysis of various pressures during transjugular intrahepatic portosystemic shunt (TIPS) procedures explored the relationship between HVPG and PPG in patients with alcoholic cirrhosis and PHT.
Research results
The correlation coefficient (r) and determination coefficient (R2) between HVPG and PPG were 0.201 and 0.040, respectively (P = 0.020). Hepatic collaterals were identified in 26 patients with balloon occlusion hepatic venography (19.4%), while the average PPG was significantly higher than the average HVPG (25.94 ± 7.42 mmHg vs 9.86 ± 7.44 mmHg; P < 0.001). The collateral versus no collateral branches groups had 3 (11.54%) and 44 (40.74%) patients, respectively, with differences of < 5 mmHg between HVPG and PPG.
Research conclusions
HVPG cannot accurately represent PPG in most patients. The formation of hepatic collaterals is a vital reason for the strong underestimation of HVPG.
Research perspectives
Based on different pressures during TIPS procedures, the correlation and differences between HVPG and PPG of patients were explored.
