Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Mar;20(1):6-14.
doi: 10.3350/cmh.2014.20.1.6. Epub 2014 Mar 26.

Hepatic venous pressure gradient: clinical use in chronic liver disease

Ki Tae Suk  1
Affiliations
Review

Hepatic venous pressure gradient: clinical use in chronic liver disease

Ki Tae Suk. Clin Mol Hepatol. 2014 Mar.

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.

Keywords: Hypertension; Liver Diseases; Portal; Portal Pressure.

PubMed Disclaimer

Conflict of interest statement

The author has no conflicts to disclose.

Figures

Figure 1
Figure 1
Preparation of HVPG measurement.
Figure 2
Figure 2
Method for HVPG measurement. HVPG, hepatic venous pressure gradient; WHVP, wedged hepatic venous pressure; FHVP, free hepatic venous pressure.
Figure 3
Figure 3
Cases with abnormal location of HVPG catheter.
Figure 4
Figure 4
Arrhythmia (supraventricular tachycardia) is developed during catheter insertion.
Figure 5
Figure 5
Artifacts are caused by abnormal location of catheter (above) and cough (below). WHVP, wedged hepatic venous pressure; FHVP, free hepatic venous pressure.
See this image and copyright information in PMC

References

    1. Sanyal AJ, Bosch J, Blei A, Arroyo V. Portal hypertension and its complications. Gastroenterology. 2008;134:1715–1728. - PubMed
    1. de Franchis R, Primignani M. Natural history of portal hypertension in patients with cirrhosis. Clin Liver Dis. 2001;5:645–663. - PubMed
    1. Burroughs AK, McCormick PA. Natural history and prognosis of variceal bleeding. Baillieres Clin Gastroenterol. 1992;6:437–450. - PubMed
    1. Krook H. Estimation of portal venous pressure by occlusive hepatic vein catheterization. Scand J Clin Lab Invest. 1953;5:285–292. - PubMed
    1. Armonis A, Patch D, Burroughs A. Hepatic venous pressure measurement: an old test as a new prognostic marker in cirrhosis? Hepatology. 1997;25:245–248. - PubMed

Publication types