Abstract
Portal hypertension (PH) is an increase in the pressure gradient between portal vein and inferior vena cava. Increased resistance occurs at different levels within the portal venous system, followed by increased portal venous inflow. PH is the main driver of cirrhosis decompensation. Varices on endoscopy or portosystemic collaterals on imaging indicate PH. Although its cause is determined mostly via noninvasive tests, the gold standard to measure portal pressure in cirrhosis and determine its severity is hepatic vein catheterization with determination of the hepatic venous pressure gradient. Measuring portal pressure is essential in proof-of-concept studies of portal pressure-lowering drugs.
Keywords:
Ascites; Bleeding; Cirrhosis; Gastroesophageal varices; Hepatic venous pressure gradient; Liver stiffness.
Copyright © 2019 Elsevier Inc. All rights reserved.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Ascites / etiology
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Bacterial Translocation
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Budd-Chiari Syndrome / complications
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Catheterization
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Coloring Agents
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Elasticity Imaging Techniques
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Endoscopy, Digestive System
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Endothelium, Vascular / physiopathology
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Esophageal and Gastric Varices / diagnosis
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Esophageal and Gastric Varices / etiology
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Esophageal and Gastric Varices / physiopathology*
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Heart Diseases / complications
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Hepatic Stellate Cells
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Hepatic Veins
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Hepatic Veno-Occlusive Disease / complications
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Humans
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Hypertension, Portal / diagnosis
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Hypertension, Portal / etiology
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Hypertension, Portal / physiopathology*
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Indocyanine Green
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Inflammation
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Liver / diagnostic imaging
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Liver Cirrhosis / complications
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Magnetic Resonance Imaging
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Neovascularization, Pathologic
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Portal Pressure
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Splanchnic Circulation
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Spleen / diagnostic imaging
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Thrombosis
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Vascular Resistance
Substances
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Coloring Agents
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Indocyanine Green