Volume 53, Issue 11 pp. 1084-1095

ORIGINAL ARTICLE

Correlation between hepatic venous pressure gradient and portal pressure gradient in patients with autoimmune cirrhotic portal hypertension and collateral branches of the hepatic vein

Bowen Liu,

Bowen Liu

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Dan Zhang,

Dan Zhang

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Chengbin Dong,

Chengbin Dong

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Zhendong Yue,

Zhendong Yue

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Lei Wang,

Lei Wang

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Zhenhua Fan,

Zhenhua Fan

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Yifan Wu,

Yifan Wu

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Ke Zhang,

Ke Zhang

Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing, China

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Li Jiang,

Li Jiang

Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing, China

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Huiguo Ding,

Huiguo Ding

Department of Gastroenterology, Beijing YouAn Hospital, Capital Medical University, Beijing, China

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Yuening Zhang,

Yuening Zhang

Department of Gastroenterology, Beijing YouAn Hospital, Capital Medical University, Beijing, China

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Jian Wang,

Jian Wang

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Peking University, Beijing, China

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Fuquan Liu,

Corresponding Author

Fuquan Liu

[email protected]

orcid.org/0000-0003-1972-7712

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

Correspondence

Fuquan Liu, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China.

Email: [email protected]

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Bowen Liu,

Bowen Liu

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Dan Zhang,

Dan Zhang

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Chengbin Dong,

Chengbin Dong

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Zhendong Yue,

Zhendong Yue

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Lei Wang,

Lei Wang

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Zhenhua Fan,

Zhenhua Fan

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Yifan Wu,

Yifan Wu

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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Ke Zhang,

Ke Zhang

Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing, China

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Li Jiang,

Li Jiang

Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing, China

Search for more papers by this author

Huiguo Ding,

Huiguo Ding

Department of Gastroenterology, Beijing YouAn Hospital, Capital Medical University, Beijing, China

Search for more papers by this author

Yuening Zhang,

Yuening Zhang

Department of Gastroenterology, Beijing YouAn Hospital, Capital Medical University, Beijing, China

Search for more papers by this author

Jian Wang,

Jian Wang

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Peking University, Beijing, China

Search for more papers by this author

Fuquan Liu,

Corresponding Author

Fuquan Liu

[email protected]

orcid.org/0000-0003-1972-7712

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

Correspondence

Fuquan Liu, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China.

Email: [email protected]

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First published: 23 June 2023

https://doi.org/10.1111/hepr.13939

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Abstract

Aim

To assess the correlation and agreement between hepatic venous pressure gradient (HVPG) and portal pressure gradient (PPG) in patients with autoimmune liver diseases (ALD) and portal hypertension, and to investigate the extent to which hepatic vein collateralization affects the accuracy of this assessment.

Methods

Ninety-eight patients with ALD between 2017 and 2021 who underwent transjugular intrahepatic portosystemic shunt with conventional and innovative 15 mL pressurized contrast were selected to measure wedged hepatic venous pressure (WHVP) and portal venous pressure and to calculate the HVPG and PPG. Pearson's correlation was used for correlation analysis between the two groups. Bland–Altman plots were plotted to estimate the agreement between paired pressures.

Results

The r values of PPG and HVPG in the early, middle, late, and portal venous visualization were 0.404, 0.789, 0.807, and 0.830, respectively, and the R² values were 0.163, 0.622, 0.651, and 0.690, respectively. The p value for the r and R² values in the early group was 0.015, and the p values in the remaining groups were less than 0.001. Bland–Altman plots showed that patients in the portal venous visualization group had the narrowest 95% limits of agreement. The mean value of the difference was close to the zero-scale line.

Conclusions

In patients with ALD, the correlation between the HVPG and PPG was good, and the later the collateral development, the better the correlation. Hepatic vein collateral was an essential factor in underestimating WHVP and HVPG, and the earlier the collateral appeared, the more obvious the underestimation.

Graphical Abstract

Our study confirmed that the correlation between the wedged hepatic venous pressure (WHVP) and portal venous pressure groups and between the hepatic venous pressure gradient (HVPG) and portal pressure gradient groups was better in both triphasic shunting and portal vein visualization by innovative angiography, with the best agreement in the portal vein visualization group. Hepatic vein collateral branches were an important factor in underestimating WHVP and HVPG; the earlier the appearance of collateral branches, the more pronounced the underestimation. The absence of hepatic vein collateral veins is a crucial factor in the overestimation of the WHVP and HVPG.

CONFLICT OF INTEREST STATEMENT

Authors declare no conflict of interest for this article.

Open Research

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Supporting Information

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Volume53, Issue11

November 2023

Pages 1084-1095