What is FHVP?

For many years, measuring hepatic venous pressures, both the free hepatic venous pressure (FHVP) and the WHVP, either with a wedge catheter or a balloon catheter, has been the standard approach for estimating portal venous pressure.4,5,6.

What is the normal Hvpg?

The normal HVPG value is between 1 to 5 mmHg. Pressure higher than this defines the presence of portal hypertension, regardless of clinical evidence. HVPG >or= 10 mmHg (termed clinically significant portal hypertension) is predictive of the development of complications of cirrhosis, including death.

What is hepatic venous wedge pressure?

Wedged hepatic venous pressure (WHVP) is measured by inflating a balloon at the catheter tip, thus occluding a hepatic vein branch. Measurement of the WHVP provides a close approximation of portal pressure.

How is Hvpg done?

HVPG measurements are performed under ultrasound and fluoroscopic guidance. The right internal jugular vein is commonly chosen because it provides direct continuity with the superior vena cava, right atrium, and inferior vena cava (IVC).

How do you check Hvpg?

The HVPG is defined as the difference in pressure between the portal vein and the inferior vena cava. Thus, the HVPG is equal to the WHVP value minus the FHVP value (ie, HVPG = WHVP – FHVP).

What is Presinusoidal hypertension?

Portal hypertension is defined as a pathologic elevation in portal venous pressures. The causes are classified as presinusoidal, sinusoidal, or postsinusoidal. In presinusoidal portal hypertension, there is obstruction or stenosis in the portal vein, its tributaries, or intrahepatic branches.

How is FHVP measured?

Free hepatic venous pressure (FHVP) was measured with the balloon undistended. By distending the balloon to occlude the hepatic vein, the WHVP was recorded. Comparison of FHVP and WHVP with the conventional and balloon techniques revealed a close positive correlation (r = 0.89 and 0.93, respectively).

How is portal hypertension treated?

Pharmacologic therapy for portal hypertension includes the use of beta-blockers, most commonly propranolol and nadolol. Brazilian investigators have suggested that the use of some statins (eg, simvastatin) may lower portal pressure and potentially improve the liver function.