Clin Mol Hepatol.  2012 Dec;18(4):391-396. 10.3350/cmh.2012.18.4.391.

Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea

Affiliations
  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. jyjang@schmc.ac.kr
  • 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. baiksk@yonsei.ac.kr
  • 4Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 5Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.

Abstract

BACKGROUND/AIMS
Variceal hemorrhage is one of the major complications of cirrhosis and is associated with significant mortality and morbidity. The development of gastroesophageal varices and variceal hemorrhage is the most direct consequence of portal hypertension. Correlations between the hepatic venous pressure gradient (HVPG) and first variceal hemorrhage were examined.
METHODS
Patients with cirrhosis who underwent HVPG measurement between July 2009 and September 2010 were enrolled (n=535). All patients underwent esophagogastroduodenoscopy to enable the evaluation of gastroesophageal varices.
RESULTS
The HVPG for all patients was 16.46+/-7.05 mmHg (mean+/-SD), and was significantly higher among those with first variceal hemorrhage than in those without it. The HVPG was significantly correlated with both Child-Turcotte-Pugh (r=0.488, P<0.001) and Model for End-stage Liver Disease (r=0.478, P<0.001) scores. An HVPG value of 11 mmHg was predictive of first variceal hemorrhage with a sensitivity of 92.4% and a specificity of 27.7%.
CONCLUSIONS
The HVPG was higher in patients with first variceal hemorrhage than in those without it.

Keyword

Hepatic venous pressure gradient (HVPG); Variceal hemorrhage

MeSH Terms

Adult
Catheters
Esophageal and Gastric Varices/*complications
Female
Gastrointestinal Hemorrhage/*etiology
Humans
Liver Cirrhosis/*complications/mortality
Male
Middle Aged
Republic of Korea
Retrospective Studies
Severity of Illness Index
*Venous Pressure
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