title: Comparison of hepatic venous pressure gradient and endoscopic grading of esophageal varices.
abstract: OBJECTIVE
  To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.
  
  
  METHODS
  From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.
  
  
  RESULTS
  The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (> 12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child's status (B-HVPG, P < 0.000; EH-HVGP, P < 0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.
  
  
  CONCLUSIONS
  Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger correlation than EH-HVPG.
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: EunJi
authors.initials: E
authors.lastname: Lee
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Yong Jae
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Dong Erk
authors.initials: DE
authors.lastname: Goo
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Seung Boo
authors.initials: SB
authors.lastname: Yang
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.affiliation: EunJi Lee, Yong Jae Kim, Dong Erk Goo, Hyun-Joo Kim, Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, South Korea.
authors.forename: Soung Won
authors.initials: SW
authors.lastname: Jeong
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000473:pathology*; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014682:Vena Cava, Inferior / Q000503:physiopathology*; D014690:Venous Pressure
keywords: Balloon catheter measurement; End hole catheter measurement; Endoscopic grade of esophageal varices; Esophageal varices; Hepatic venous pressure gradient; Liver cirrhosis