Hepatic Venous Pressure Gradient: Measurement and Pitfalls

Susana G Rodrigues; Maria Gabriela Delgado; Guido Stirnimann; Annalisa Berzigotti; Jaime Bosch

doi:10.1016/j.cld.2024.03.009

Hepatic Venous Pressure Gradient: Measurement and Pitfalls

Clin Liver Dis. 2024 Aug;28(3):383-400. doi: 10.1016/j.cld.2024.03.009. Epub 2024 May 1.

Authors

Susana G Rodrigues¹, Maria Gabriela Delgado², Guido Stirnimann³, Annalisa Berzigotti⁴, Jaime Bosch⁵

Affiliations

¹ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, MEM, Murtenstrasse 35 Office F807, Bern 3008, Switzerland.
² Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, MEM, Murtenstrasse 35 Office F808, Bern 3008, Switzerland.
³ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland.
⁴ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, BHH D115, Freiburgstrasse 10, Bern 3010, Switzerland.
⁵ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, MEM, Murtenstrasse 35 Office F805, Bern 3008, Switzerland; CIBEREHD (Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas), Barcelona, Spain. Electronic address: [email protected].

PMID: 38945633
DOI: 10.1016/j.cld.2024.03.009

Abstract

Measurement of hepatic venous pressure gradient (HVPG) effectively mirrors the severity of portal hypertension (PH) and offers valuable insights into prognosis of liver disease, including the risk of decompensation and mortality. Additionally, HVPG offers crucial information about treatment response to nonselective beta-blockers and other medications, with its utility demonstrated in clinical trials in patients with PH. Despite the widespread dissemination and validation of noninvasive tests, HVPG still holds a significant role in hepatology. Physicians treating patients with liver diseases should comprehend the HVPG measurement procedure, its applications, and how to interpret the results and potential pitfalls.

Keywords: Beta-blockers invasive; Catheterization; Cirrhosis; HVPG; Portal hypertension; Portal pressure monitoring.

Publication types

Review

MeSH terms

Hepatic Veins / physiopathology
Humans
Hypertension, Portal* / diagnosis
Hypertension, Portal* / physiopathology
Portal Pressure*
Prognosis
Severity of Illness Index