HVPG as a Predictor of Mortality in Non-Critically-Ill Cirrhotic Patients

HVPG as a Predictor of Mortality in Non-Critically-Ill Cirrhotic Patients

Portal hypertension (PH) is defined as an increased portal venous pressure gradient above 5 mmHg, and is closely related to complications and mortality of cirrhosis.1 In particular, PH is greatly important before the onset of decompensation state where the degree of PH is well correlated to the prognosis. Portal pressure is known to be more useful in predicting development of complications of cirrhosis in chronic liver disease than the degree of fibrosis observed in liver biopsy. Direct measurement of portal pressure is excessively invasive and no longer used in clinical practice. Instead, because hepatic venous pressure gradient (HVPG) is safe, reproducible, and relatively less invasive, it is most widely used and standard test that reflects portal pressure. Recently, HVPG has been used in variety of fields such as diagnosis and prognosis of cirrhosis, risk stratification, monitoring therapeutic response of beta- blocker, and prediction of development of hepatocellular carcinoma.2

Portal hypertension (PH) is defined as an increased portal venous pressure gradient above 5 mmHg, and is closely related to complications and mortality of cirrhosis.1 In particular, PH is greatly important before the onset of decompensation state where the degree of PH is well correlated to the prognosis. Portal pressure is known to be more useful in predicting development of complications of cirrhosis in chronic liver disease than the degree of fibrosis observed in liver biopsy. Direct measurement of portal pressure is excessively invasive and no longer used in clinical practice. Instead, because hepatic venous pressure gradient (HVPG) is safe, reproducible, and relatively less invasive, it is most widely used and standard test that reflects portal pressure. Recently, HVPG has been used in variety of fields such as diagnosis and prognosis of cirrhosis, risk stratification, monitoring therapeutic response of beta- blocker, and prediction of development of hepatocellular carcinoma.2