title: Portal hypertensive gastropathy as a prognostic index in patients with liver cirrhosis.
abstract: BACKGROUND
  Portal hypertensive gastropathy (PHG) is a frequently overlooked complication of liver cirrhosis (LC). The clinical implications of PHG as a prognostic factor of LC or a predictive factor for the development of hepatocellular carcinoma (HCC) have not been established. The aim of this study was to assess the clinical significance of PHG in patients with LC.
  
  
  METHODS
  Patients with LC were prospectively enrolled and followed in a single tertiary hospital in the Republic of Korea. Baseline hepatic vein pressure gradient (HVPG) was measured, and esophagogastroduodenoscopy (EGD) was performed. The associations of PHG with HVPG, survival and the development of HCC were evaluated.
  
  
  RESULTS
  A total of 587 patients were enrolled. The mortality rate was 20.3 % (n = 119), and HCC developed in 9.2 % (n = 54) during the follow-up period (32.6 ± 27.8 months). The grade of PHG was well correlated with HVPG (no PGH: median 9.2 [IQR: 7.2-16.7], mild PHG: 14.6 [10.1-19.3], and severe PHG: 17.3 [12.3-21.5], P < 0.001), as well as with Child-Pugh class, MELD score or survival. However, it was not associated with the development of HCC. The grade of PHG (HR 3.29, 95 % CI: 1.12-9.63, severe vs. no PHG) and Child-Pugh class (HR 3.53, 95 % CI: 1.79-6.97, Child C vs A) showed significant associations with mortality.
  
  
  CONCLUSIONS
  PHG was well correlated with portal hypertension and could be used as a prognostic factor for LC but not for the prediction of HCC.
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Chang Seok
authors: CS
authors: Bang
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Hyo Sun
authors: HS
authors: Kim
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Ki Tae
authors: KT
authors: Suk
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Sung Eun
authors: SE
authors: Kim
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Ji Won
authors: JW
authors: Park
authors: Department of Internal Medicine, Inje University Haeundae-Paik Hospital, Busan, South Korea.
authors: Seung Ha
authors: SH
authors: Park
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Hyoung Su
authors: HS
authors: Kim
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Myoung Kuk
authors: MK
authors: Jang
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Sang Hoon
authors: SH
authors: Park
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Myung Seok
authors: MS
authors: Lee
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea.
authors: Choong Kee
authors: CK
authors: Park
authors: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon-do, 24253, South Korea. djkim@hallym.ac.kr.
authors: Dong Joon
authors: DJ
authors: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013272:Stomach Diseases / Q000209:etiology*; D015996:Survival Rate
keywords: Cirrhosis; Hepatocellular carcinoma; Portal hypertension; Portal hypertensive gastropathy