Numerical assessment of portal pressure gradient (PPG) based on clinically measured hepatic venous pressure gradient (HVPG) for liver cirrhosis patients

Yue Qiu; Yang Tai; Ying Li; Qu Wei; Hao Wu; Kang Li

doi:10.1016/j.jbiomech.2025.112498

Numerical assessment of portal pressure gradient (PPG) based on clinically measured hepatic venous pressure gradient (HVPG) for liver cirrhosis patients

J Biomech. 2025 Jan 2:180:112498. doi: 10.1016/j.jbiomech.2025.112498. Online ahead of print.

Authors

Yue Qiu¹, Yang Tai², Ying Li², Qu Wei³, Hao Wu⁴, Kang Li⁵

Affiliations

¹ Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China; Biofluid Lab, Sichuan University-Pittsburgh Institute, Sichuan University, PR China.
² Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
³ Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China.
⁴ Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China. Electronic address: [email protected].
⁵ Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China. Electronic address: [email protected].

PMID: 39787772
DOI: 10.1016/j.jbiomech.2025.112498

Abstract

Portal hypertension (PH) is the initial and main consequence of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement has been widely used to estimate portal pressure gradient (PPG) and detect portal hypertension. However, some clinical studies have found poor correlation between HVPG and PPG, which may lead to the misdiagnosis of portal hypertension. In this study, we provided a method to evaluate patients' PPG based on clinically measured HVPG with computational fluid dynamics (CFD). Twenty-five patients who underwent HVPG measurement were recruit for analysis. Results show that HVPG significantly correlates with PPG (R = 0.7499, P < 0.0001), with an accuracy to distinguish clinically significant portal hypertension (CSPH) as high as 92 %. However, PH severity classification was underestimated for 36 % patients, especially for patients with hepatic venous collateral formation and presinusoidal portal vein occlusion. It is concluded that HVPG is a relatively reliable diagnostic method for PH when PPG cannot be directly measured. For patients who have clinical symptoms of PH but their HVPG are within a normal range, numerical evaluation of PPG with CFD is an excellent way for their diagnosis.

Keywords: Computational fluid dynamics (CFD); Hepatic venous pressure gradient (HVPG); Liver cirrhosis; Portal hypertension; Portal pressure gradient (PPG).