THE ROLE OF INVASIVE AND NON-INVASIVE MEASUREMENTS OF HVPG IN DECISION MAKING IN PATIENTS WITH PORTAL HYPERTENSIONAND ESOPHAGEAL VARICES

• Published in: Wiadomości lekarskie (1960) Vol. 74; no. 2; p. 321
• Main Authors: Kern, Adam, Arłukowicz, Tomasz, Bojko, Krystian, Gromadziński, Leszek, Bil, Jacek
• Format: Journal Article
• Language: English
• Published: Poland 2021
• Subjects: Decision Making; Esophageal and Gastric Varices - pathology; Humans; Hypertension, Portal - complications; Hypertension, Portal - diagnosis; Hypertension, Portal - pathology; Liver - pathology; Liver Cirrhosis - complications; Portal Pressure; hepatic venous pressure gradient; elastography; spleen stiffness; wedged hepatic vein pressure
• ISSN: 0043-5147
• DOI: 10.36740/wlek202102128

Many researchers and clinicians have taken the value of hepatic venous pressure gradient (HVPG) as an essential prognostic factor in subjects with chronic liver disorders. And HVPG alterations characterize a predictive value in subjects at the beginning of the disease (HVPG 6 - 10 mmHg) as well as in subjects in whom hemodynamically significant portal hypertension has developed (HVPG ≥ 10 mmHg). Our review aims to present the feasibility and applicability of HVPG in modern clinical practice in patients with liver cirrhosis, including invasive and non-invasive methods. HVPG measurement is a feasible method with a favorable safety profile. However, hemodynamically significant portal hypertension also might be determined using non-invasive options as elastography, magnetic resonance imaging, and indices derived from laboratory parameters, e.g., aspartate aminotransferase-to-platelet ratio, platelet count/spleen diameter ratio, or VITRO score. Hepatic vein catheterization with the evaluation of HVPG is the current gold standard for determining portal pressure; however, new non-invasive techniques are nowadays more frequently used.