Korean J Med.  2008 Jul;75(1):1-5.

Pathophysiology and diagnosis of portal hypertension

• Kim MY

Abstract

Portal hypertension (PHT) as a consequence of liver cirrhosis is responsible for serious complications such as variceal bleeding, ascites and hepatic encehphalopathy. PHT is caused by increased intrahepatic vascular resistance and maintained by increased portal venous inflow. Increased intrahepatic vascular resistance has some reversible dynamic components related with activated hepatic stellate cell(HSC) and vacular activation mediators, therefore which come into the spotlight as new targets in treatment of PHT. PHT also induces hyperdynamic circulation by reduced systemic vascular resistance (SVR) and increased cardiac output. The gold-standard method for assessing the severity of PHT is a measurement of the hepatic venous pressure gradient (HVPG). However it is invasive, so non-invasive methods such as Doppler ultrasonography is under investigation as additive method.

Keyword

Portal hypertension; Intrahepatic vascular resistance; Hyperdynamic circulation; Hepatic stellate cell; Hepatic venous pressure gradient

MeSH Terms

Ascites
Cardiac Output
Hemorrhage
Hepatic Stellate Cells
Hypertension
Hypertension, Portal
Liver Cirrhosis
Ultrasonography, Doppler
Vascular Resistance
Venous Pressure