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Hepatic venous pressure gradient: clinical use in chronic liver disease.

Suk KT - Clin Mol Hepatol (2014)

Bottom Line: Patients who had a reduction in HVPG of ≥ 20% or to ≤ 12 mmHg in response to drug therapy are defined as responders.Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival.This review provides clinical use of HVPG measurement in the field of liver disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.

ABSTRACT
Portal hypertension is a severe consequence of chronic liver diseases and is responsible for the main clinical complications of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement is the best available method to evaluate the presence and severity of portal hypertension. Clinically significant portal hypertension is defined as an increase in HVPG to >10 mmHg. In this condition, the complications of portal hypertension might begin to appear. HVPG measurement is increasingly used in the clinical fields, and the HVPG is a robust surrogate marker in many clinical applications such as diagnosis, risk stratification, identification of patients with hepatocellular carcinoma who are candidates for liver resection, monitoring of the efficacy of medical treatment, and assessment of progression of portal hypertension. Patients who had a reduction in HVPG of ≥ 20% or to ≤ 12 mmHg in response to drug therapy are defined as responders. Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival. This review provides clinical use of HVPG measurement in the field of liver disease.

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Arrhythmia (supraventricular tachycardia) is developed during catheter insertion.
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Figure 4: Arrhythmia (supraventricular tachycardia) is developed during catheter insertion.

Mentions: Only minor complications such as mainly transient cardiac arrhythmias, local pain, or vagal reaction have been reported and these occur infrequently (< 1% of patients) (Fig. 4). Until now, no deaths have occurred. HVPG measurements can be performed in 10 minutes with trans-jugular liver biopsy through the same route. Despite its advantages such as safety, feasibility, and reproducibility, the technique is invasive. In addition, HVPG procedure shows low acceptance rate among patients with chronic liver disease and requires technical expertise typically found at tertiary medical centers.28,29


Hepatic venous pressure gradient: clinical use in chronic liver disease.

Suk KT - Clin Mol Hepatol (2014)

Arrhythmia (supraventricular tachycardia) is developed during catheter insertion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3992331&req=5

Figure 4: Arrhythmia (supraventricular tachycardia) is developed during catheter insertion.
Mentions: Only minor complications such as mainly transient cardiac arrhythmias, local pain, or vagal reaction have been reported and these occur infrequently (< 1% of patients) (Fig. 4). Until now, no deaths have occurred. HVPG measurements can be performed in 10 minutes with trans-jugular liver biopsy through the same route. Despite its advantages such as safety, feasibility, and reproducibility, the technique is invasive. In addition, HVPG procedure shows low acceptance rate among patients with chronic liver disease and requires technical expertise typically found at tertiary medical centers.28,29

Bottom Line: Patients who had a reduction in HVPG of ≥ 20% or to ≤ 12 mmHg in response to drug therapy are defined as responders.Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival.This review provides clinical use of HVPG measurement in the field of liver disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.

ABSTRACT
Portal hypertension is a severe consequence of chronic liver diseases and is responsible for the main clinical complications of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement is the best available method to evaluate the presence and severity of portal hypertension. Clinically significant portal hypertension is defined as an increase in HVPG to >10 mmHg. In this condition, the complications of portal hypertension might begin to appear. HVPG measurement is increasingly used in the clinical fields, and the HVPG is a robust surrogate marker in many clinical applications such as diagnosis, risk stratification, identification of patients with hepatocellular carcinoma who are candidates for liver resection, monitoring of the efficacy of medical treatment, and assessment of progression of portal hypertension. Patients who had a reduction in HVPG of ≥ 20% or to ≤ 12 mmHg in response to drug therapy are defined as responders. Responders have a markedly decreased risk of bleeding/rebleeding, ascites, and spontaneous bacterial peritonitis, which results in improved survival. This review provides clinical use of HVPG measurement in the field of liver disease.

Show MeSH
Related in: MedlinePlus