HVPG = WHVP - Free Hepatic venous pressures
- WHVP = Wedged hepatic venous pressure
- gradient between pressures in the portal vein and the intra-abdominal portion of IVC
- When blood flow in a hepatic vein is stopped by a wedged catheter, the proximal static column of blood transmits the pressure from the preceding communicated vascular territory (hepatic sinusoids) to the catheter. Thus, WHVP reflects hepatic sinusoidal pressure.
- In the normal liver, due to pressure equilibration through interconnected sinusoids, wedged pressure is slightly lower than portal pressure, though this difference is clinically insignificant.
➡️ While in Cirrhosis , Sinusoidal interconnection are lost. Therefore, WHVP gives an accurate estimation of portal pressure in cirrhosis !!!
Normal HVPG = 1-5 mm hg
HVPG >5 = Portal HTN
HVPG > 10 = Clinically Significant portal HTN
HVPG > 12 = Threshold for Variceal Rupture = So use Beta Blocker to ⬇️ it.
Measurement of the Hepatic Venous Pressure Gradient (HVPG)
Thank you ! 🩺
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