Hepatic venous pressure gradient determination in patients with HCV-related and alcoholic cirrhosis

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Eur J Gastroenterol Hepatol. 2003 Oct;15(10):1085-9.

Hepatic venous pressure gradient determination in patients with

hepatitis C virus-related and alcoholic cirrhosis.

Bellis L, Castellacci R, Montagnese F, Festuccia F, Corvisieri P, Puoti

C.

Department of Gastroenterology and Internal Medicine, Genzano Hospital

E. De Santis, Rome, Italy.

OBJECTIVES: Few data exist regarding the degree of portal hypertension

in hepatitis C virus (HCV)-related cirrhosis, as the majority of studies

have included mainly patients with alcoholic cirrhosis. This study was

aimed at comparing the severity of portal hypertension in patients with

HCV-related or alcoholic cirrhosis. METHODS: In total, 59 cirrhotic

patients with portal hypertension (HCV-related in 34 cases and alcoholic

in 25) underwent main right hepatic vein catheterization, with

determination of the wedged and free hepatic venous pressures, and of

hepatic venous pressure gradient (HVPG). RESULTS: HVPG values did not

differ between the two groups of patients (19.4 +/- 6.0 mmHg vs 18.5 +/-

3.5 mmHg; P = 0.51). The prevalence and degree of oesophageal and

gastric varices and portal hypertensive gastropathy did not correlate

with the aetiology. Patients with viral cirrhosis had a lower prevalence

of previous bleeding than those with alcoholic cirrhosis, despite a

similar proportion of large varices in the two groups and similar HVPG

levels. In both groups of patients, HVPG did not differ between patients

with previous bleeds and those without.

CONCLUSIONS: The degree of portal hypertension in cirrhotic patients

does not correlate with the cause of the disease. Thus, current

statements on the management of portal hypertension, although based upon

studies including mainly patients with alcoholic cirrhosis, can be

applied also to patients with viral-related cirrhosis.

PMID: 14501616

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