WHVP is used to estimate the portal venous pressure by reflecting not the actual hepatic portal vein pressure but the hepatic sinusoidal pressure. It is determined by wedging a catheter in a hepatic vein, to occlude it, and then measuring the pressure of proximal static blood (which is reflective of pressure in the sinusoids). WHVP in fact slightly underestimates portal pressure due to sinusoidal equilibration in patients without cirrhosis, but the difference between the two is clinically insignificant. In patients with cirrhotic livers intersinusoidal communication is disrupted such that sinusoidal pressure equilibrium cannot be maintained, and so WHVP becomes a far more accurate measure of portal venous pressure.[citation needed]
Hepatic venous pressure gradient (HVPG)edit
HVPG is a clinical measurement of the pressure gradient between the WHVP and the free hepatic venous pressures (FHPV), and thus is an estimate of the pressure gradient between the portal vein and the inferior vena cava. An HVPG of ≥5 mmHg defines portal hypertension, and if the measurement exceeds 10 mmHg it is called clinically significant portal hypertension. Above 12 mm Hg, variceal haemorrhage may occur.[5] While not widely performed, its assessment in people with chronic liver disease is recommended to monitor response to treatment.[6]
^Castell, Donald O. (1967). "Ascites in cirrhosis". The American Journal of Digestive Diseases. 12 (9): 916–922. doi:10.1007/BF02236449. PMID 6039572. S2CID 28150018.
^"Portal Hypertension". Postgrad Med J. 23 (264): 451–68. Oct 1947. doi:10.1136/pgmj.23.264.451-a. PMC2529595. PMID 21313474.
^Sauerbruch, T.; Trebicka, J. (2014). "Future therapy of portal hypertension in liver cirrhosis - a guess". F1000Prime Rep. 6: 95. doi:10.12703/P6-95. PMC4191223. PMID 25374673.
^Kumar, A.; Sharma, P.; Sarin, S. K. (2008). "Hepatic venous pressure gradient measurement: Time to learn!". Indian Journal of Gastroenterology. 27 (2): 74–80. PMID 18695309.
^Triantos, C. K.; Nikolopoulou, V.; Burroughs, A. K. (2008). "Review article: The therapeutic and prognostic benefit of portal pressure reduction in cirrhosis". Alimentary Pharmacology & Therapeutics. 28 (8): 943–952. doi:10.1111/j.1365-2036.2008.03798.x. PMID 18627364.
portal, venous, pressure, blood, pressure, hepatic, portal, vein, normally, between, mmhg, raised, portal, venous, pressure, termed, portal, hypertension, numerous, sequelae, such, ascites, hepatic, encephalopathy, contents, wedged, hepatic, venous, pressure, . Portal venous pressure is the blood pressure in the hepatic portal vein and is normally between 5 10 mmHg 1 Raised portal venous pressure is termed portal hypertension 2 and has numerous sequelae such as ascites and hepatic encephalopathy 3 4 Contents 1 Wedged hepatic venous pressure WHVP 2 Hepatic venous pressure gradient HVPG 3 References 4 External linksWedged hepatic venous pressure WHVP editWHVP is used to estimate the portal venous pressure by reflecting not the actual hepatic portal vein pressure but the hepatic sinusoidal pressure It is determined by wedging a catheter in a hepatic vein to occlude it and then measuring the pressure of proximal static blood which is reflective of pressure in the sinusoids WHVP in fact slightly underestimates portal pressure due to sinusoidal equilibration in patients without cirrhosis but the difference between the two is clinically insignificant In patients with cirrhotic livers intersinusoidal communication is disrupted such that sinusoidal pressure equilibrium cannot be maintained and so WHVP becomes a far more accurate measure of portal venous pressure citation needed Hepatic venous pressure gradient HVPG editHVPG is a clinical measurement of the pressure gradient between the WHVP and the free hepatic venous pressures FHPV and thus is an estimate of the pressure gradient between the portal vein and the inferior vena cava An HVPG of 5 mmHg defines portal hypertension and if the measurement exceeds 10 mmHg it is called clinically significant portal hypertension Above 12 mm Hg variceal haemorrhage may occur 5 While not widely performed its assessment in people with chronic liver disease is recommended to monitor response to treatment 6 References edit eMedicine Esophageal Varices Castell Donald O 1967 Ascites in cirrhosis The American Journal of Digestive Diseases 12 9 916 922 doi 10 1007 BF02236449 PMID 6039572 S2CID 28150018 Portal Hypertension Postgrad Med J 23 264 451 68 Oct 1947 doi 10 1136 pgmj 23 264 451 a PMC 2529595 PMID 21313474 Sauerbruch T Trebicka J 2014 Future therapy of portal hypertension in liver cirrhosis a guess F1000Prime Rep 6 95 doi 10 12703 P6 95 PMC 4191223 PMID 25374673 Kumar A Sharma P Sarin S K 2008 Hepatic venous pressure gradient measurement Time to learn Indian Journal of Gastroenterology 27 2 74 80 PMID 18695309 Triantos C K Nikolopoulou V Burroughs A K 2008 Review article The therapeutic and prognostic benefit of portal pressure reduction in cirrhosis Alimentary Pharmacology amp Therapeutics 28 8 943 952 doi 10 1111 j 1365 2036 2008 03798 x PMID 18627364 External links editPortal Pressure at the U S National Library of Medicine Medical Subject Headings MeSH Retrieved from https en wikipedia org w index php title Portal venous pressure amp oldid 1175774475 Hepatic venous pressure gradient HVPG, wikipedia, wiki, book, books, library,
