Comparison of Doppler ultrasonography and the hepatic venous pressure gradient in assessing portal hypertension in liver cirrhosis.
OBJECTIVE
This prospective study aimed to determine whether Doppler ultrasonography can represent the hepatic venous pressure gradient (HVPG) as an assessment of the severity of portal hypertension and the response to terlipressin, which reduces the portal pressure in liver cirrhosis.


METHODS
The HVPG and the Doppler ultrasonographic parameters, such as the portal venous velocity and the splenic venous velocity, the pulsatility and the resistive index of the hepatic, splenic and renal arteries were measured in 138 patients with liver cirrhosis. The changes in the HVPG and the portal venous velocity after administering terlipressin were evaluated in 43 of the 138 patients. The patients who showed a reduction in the HVPG of more than 20% of the baseline were defined as responders to terlipressin.


RESULTS
None of the Doppler ultrasonographic parameters correlated with the HVPG. Both the HVPG (28.0 +/- 19.8%) and the portal venous velocity (29.7 +/- 13.2%) showed a significant reduction after terlipressin administration. However, the portal venous velocity decreased significantly, not only in the responders (31.0 +/- 12.0%) but also in the non-responders (25.2 +/- 16.4%).


CONCLUSIONS
Doppler ultrasonography does not represent the HVPG, and is therefore not suitable for replacing HVPG as a means of assessing the severity of portal hypertension and the response to drugs which reduce the portal pressure in liver cirrhosis.
Choi
Yeun Jong
YJ
Departments of Internal Medicine, Wonju College of Medicine, Wonju, Korea.
Baik
Soon Koo
SK
Park
Dong Hoon
DH
Kim
Moon Young
MY
Kim
Hyun Soo
HS
Lee
Dong Ki
DK
Kwon
Sang Ok
SO
Kim
Young Ju
YJ
Park
Joong Wha
JW
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects / Q000502:physiology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D000077585:Terlipressin; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology
D000959:Antihypertensive Agents; D008236:Lypressin; D000077585:Terlipressin