Euroasian Journal of Hepato-Gastroenterology

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VOLUME 7 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding

Ahmed L Moben, Mohammad A Alam, Sheikh M Noor E Alam, Faiz A Khondaker, Masuda Mohsena

Citation Information : Moben AL, Alam MA, Noor E Alam SM, Khondaker FA, Mohsena M. Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding. Euroasian J Hepatogastroenterol 2017; 7 (2):142-145.

DOI: 10.5005/jp-journals-10018-1235

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child—Pugh status, and variceal bleeding.

Materials and methods

A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject. Severity of cirrhosis was assessed by Child's status.

Results

The mean HVPG was higher in patients with Child's B and C (14.10 ± 7.56 and 13.64 ± 7.17 mm Hg respectively) compared with those of Child's A (10.15 ± 5.63 mm Hg). The levels of HVPG differed significantly between Child's classes A and B (p = 0.011) and Child's A and C (p = 0.041). The mean HVPG was also higher in bleeders compared with nonbleeders with large varices (17.7 ± 5.5 vs 14.9 ± 4.7 mmHg respectively; p = 0.006).

Conclusion

Hepatic venous pressure gradient seems to be important to assess the severity of liver cirrhosis.

How to cite this article

Al Mahtab M, Noor E Alam SM, Rahim MA, Alam MA, Khondaker FA, Moben AL, Mohsena M, Akbar SMF. Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding. Euroasian J Hepato-Gastroenterol 2017;7(2):142-145.


  1. Complications of cirrhosis. I. Portal hypertension. J Hepatol 2000;32(1 Suppl):141-156.
  2. Changing clinical practice with measurements of portal pressure. Hepatology 2004 Feb;39(2):283-285.
  3. Use of portal pressure studies in management of variceal hemorrhage. World J Gastrointest Endosc 2012 Jul;4(7):281-289.
  4. Hepatic venous pressure gradient determination in patients with hepatitis C virus-related and alcoholic cirrhosis. Eur J Gastroenterol Hepatol 2003 Oct;15(10):1085-1089.
  5. Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus-related cirrhosis. Hepatology 1999 Dec;30(6):1393-1397.
  6. Hepatic venous pressure gradient measurement: time to learn! Indian J Gastroenterol 2008 Mar-Apr;27(2):74-80.
  7. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology 2006 Nov;131(5):1611-1624.
  8. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 1988 Oct;319(15):983-989.
  9. Prognostic value of hepatic venous pressure gradient measurements in alcoholic cirrhosis: a 10year prospective study. Gastroenterology 1996 Sep;111(3):701-709.
  10. Hemodynamic parameters predicting variceal haemorrhage and survival in alcoholic cirrhosis. QJM 1998 Jan;91(1):19-25.
  11. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology 2007 Sep;46(3):922-938.
  12. Measurement of portal pressure: when, how, and why to do it. Clin Liver Dis 2006 Aug;10(3):499-512, viii.
  13. Hepatic venous pressure gradient in cirrhosis: correlation with the size of varices, bleeding, ascites, and child's status. Dig Dis Sci 2006 Dec;51(12):2264-2269.
  14. Correlation of HVPG level with CTP score, MELD Score, ascites, size of varices, and etiology in cirrhotic patients. Saudi J Gastroenterol 2016 Mar-Apr;22(2):109-115.
  15. Endoscopic variceal prophylaxis of first variceal bleeding in cirrhotic patients with high-risk esophageal varices. Hepatology 1997 Jun;25(6):1346-1350.
  16. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin Liver Dis 1999;19(4):475-505.
  17. A placebo-controlled clinical trial of nadolol in the prophylaxis of growth of small esophageal varices in cirrhosis. Gastroenterology 2004 Aug;127(2):476-484.
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