Portal hypertensive gastropathy: correlation with portal hypertension and prognosis in cirrhosis.
BACKGROUND
Portal hypertensive gastropathy (PHG) is a common endoscopic finding in patients with cirrhosis. However, the relationship between PHG and portal hypertension is controversial. Furthermore, nothing is known regarding the correlation between PHG and prognosis in patients with cirrhosis.


METHODS
The hepatic venous pressure gradient (HVPG), endoscopic PHG grade, Child-Pugh score, and model for end-stage liver disease (MELD) score were assessed at baseline and were followed prospectively in 331 cirrhotic patients (284 males, 85.8%; mean age, 52.16 ± 9.05 years) from January 2001 to April 2009. The relationship between PHG with HVPG and survival was investigated.


RESULTS
The HVPG was significantly higher in patients with severe PHG than in those with mild or no PHG (absent, 4.9 ± 1.7 mmHg; mild, 10.7 ± 4.1 mmHg; severe, 15.6 ± 4.6 mmHg; P < 0.001). During follow-up, 28 patients (8.5%) died from liver-related disease. In the Cox regression analysis, severe PHG (none and mild vs. severe) (hazard ratio 1.153, 95% confidence interval: 1.048-1.269) showed a significantly high relative risk of mortality, and in the Kaplan-Meier analysis, severe PHG showed a significantly shorter expected survival time than none or mild PHG (median survival time, 77.6 ± 9.6 months in severe PHG; log-rank test, P = 0.030).


CONCLUSIONS
PHG was associated with portal hypertension severity and prognosis in patients with cirrhosis.
Kim
Moon Young
MY
Department of Internal Medicine and Institute of Basic Medical Science, Yonsei University, Wonju College of Medicine, Wonju, South Korea.
Choi
Hoon
H
Baik
Soon Koo
SK
Yea
Chang Jin
CJ
Won
Chan Sik
CS
Byun
Jong Won
JW
Park
So Yeon
SY
Kwon
Yong Hwan
YH
Kim
Jae Woo
JW
Kim
Hyun Soo
HS
Kwon
Sang Ok
SO
Kim
Young Ju
YJ
Cha
Seung Hwan
SH
Chang
Sei Jin
SJ
D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D013272:Stomach Diseases / Q000209:etiology* / Q000503:physiopathology
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