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Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus–related cirrhosis
Author(s) -
Escorsell Àngels,
Bru Concepció,
Gilabert Rosa,
Moitinho Eduardo,
GarcíaPagán Juan Carlos,
Bosch Jaume
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510300628
Subject(s) - portal venous pressure , medicine , cirrhosis , portal hypertension , alcoholic liver disease , gastroenterology , liver disease , propranolol , chronic liver disease , intraclass correlation , hepatitis c virus , alcoholic hepatitis , virus , immunology , clinical psychology , psychometrics
Wedged hepatic venous pressure (WHVP) is equivalent to portal venous pressure in patients with alcoholic liver diseases. However, it may underestimate portal pressure in nonalcoholics, which is important because hepatitis C virus (HCV) infection is a frequent cause of chronic liver disease. We investigated the agreement between directly measured portal pressure and WHVP in alcoholic and HCV–related liver diseases. Seventy‐one patients with liver disease resulting from HCV infection (n = 32), alcohol (n = 25), or both (n = 14) underwent simultaneous measurements of WHVP (by hepatic vein catheterization) and portal pressure (by direct puncture). In 9 patients, measurements were repeated 20 minutes after acute iv propranolol administration. WHVP showed an excellent agreement with portal pressure in patients with cirrhosis resulting from either HCV, alcohol or both (intraclass correlation coefficient: 0.94, 0.93, and 0.97, respectively; P < .001). A discrepancy of ≥5 mm Hg was observed in 7 cases. WHVP underestimated portal pressure in only 1 case and exceeded portal pressure by ≥5 mm Hg in 6 patients. The WHVP response to propranolol closely and significantly correlated with changes in portal pressure (intraclass correlation coefficient: 0.87; P < .004). The simple and safe measurement of WHVP accurately reflects portal pressure in alcoholic and HCV–related liver disease. This technique also allows us to accurately assess the portal pressure response to propranolol in both alcoholic and HCV–related cirrhosis.