Agreement between Wedged Hepatic Venous Pressure and Portal Pressure in Hepatic Sinusoidal Obstruction Syndrome

Yang Cheng; Lihong Gu; Xiaochun Yin; Xixuan Wang; Jiangqiang Xiao; Yi Wang; Wei Zhang; Lei Wang; Xiaoping Zou; Ming Zhang; Yuzheng Zhuge; Feng Zhang

doi:10.3390/jpm13010004

Agreement between Wedged Hepatic Venous Pressure and Portal Pressure in Hepatic Sinusoidal Obstruction Syndrome

J Pers Med. 2022 Dec 20;13(1):4. doi: 10.3390/jpm13010004.

Authors

Yang Cheng^{1

2}, Lihong Gu¹, Xiaochun Yin¹, Xixuan Wang³, Jiangqiang Xiao¹, Yi Wang¹, Wei Zhang¹, Lei Wang¹, Xiaoping Zou¹, Ming Zhang¹, Yuzheng Zhuge², Feng Zhang^{1

2}

Affiliations

¹ Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
² Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing 210008, China.
³ Department of Gastroenterology, Medical School of Southeast University Nanjing Drum Tower Hospital, Nanjing 210008, China.

Abstract

Background: Wedge hepatic vein pressure (WHVP) accurately estimates the portal pressure (PP) in chronic sinusoidal portal hypertension patients. Whether this applies to patients with acute portal hypertension due to hepatic sinusoidal obstruction syndrome (HSOS) is unclear. Our aim was to assess the agreement between WHVP and PP in patients with HSOS by comparing them to decompensated cirrhosis patients. Methods: From December 2013 to December 2021, patients with pyrrolidine alkaloid-induced HSOS (PA-HSOS) receiving hepatic venous pressure gradient (HVPG) measurement and transjugular intrahepatic portosystem shunt (TIPS) were retrospectively collected and matched with those of patients with virus- or alcohol-related cirrhosis as a cirrhosis group. Pearson’s correlation (R), intraclass correlation coefficient (ICC), scatter plots, and the Bland−Altman method were performed for agreement evaluation. Results: A total of 64 patients were analyzed (30 PA-HSOS and 34 cirrhosis groups). The correlation between WHVP and PP was moderate in the PA-HSOS group (R: 0.58, p = 0.001; ICC: 0.68, p = 0.002) but good in the cirrhosis group (R: 0.81, p < 0.001; ICC: 0.90, p < 0.001). The percentage of patients with inconsistent WHVP and PP in the two groups was 13 (43.3%) and 15 (26.5%) (p = 0.156), respectively, and an overestimation of PP was more common in the PA-HSOS group (33.3% vs. 2.9%, p = 0.004). HVPG and portal pressure gradient (PPG) consistency was poor in both groups (R: 0.51 vs. 0.26; ICC: 0.65 vs. 0.41; p < 0.05). Conclusions: WHVP in patients with PA-HSOS did not estimate PP as accurately as in patients with virus- or alcohol-related cirrhosis, which was mainly due to PP overestimation.

Keywords: hepatic sinusoidal obstruction syndrome; hepatic venous pressure gradient; portal hypertension; portal pressure; wedged hepatic vein pressure.

Grants and funding

This research was funded by the National Natural Science Foundation of China (no. 81900552), Nanjing Health Science and Technology Development Fund for Distinguished Young Youths (JQX20005), Nanjing Medical Science and Technique Development Foundation (no. ZKX19015), Special Fund Project for Clinical Research of Nanjing Drum Tower Hospital (2022-LCYJ-MS-13, 2022-LCYJ-MS-17).