Background & Aims Hepatic venous pressure gradient (HVPG) has a strong predictive value for variceal rebleeding in cirrhotic patients, but the accuracy of an HVPG may be compromised in nonalcoholic steatohepatitis (NASH) cirrhosis. This study aimed to evaluate the accuracy of HVPG and portal pressure gradient (PPG) for predicting rebleeding in NASH cirrhosis after acute variceal bleeding. Patients and Methods Thirty-eight NASH cirrhosis patients and 82 hepatitis B virus (HBV) cirrhosis patients with acute variceal bleeding were included in this study. All patients recived transjugular intrahepatic portalsystemic shunt (TIPS). The prognostic value of HVPG and PPG for variceal rebleeding was evaluated. Results Compared with HBV cirrhosis, NASH cirrhosis demonstrated a lower portal pressure (26.3 ± 6.1 vs. 30.1 ± 4.7; P <0.001), lower wedge hepatic venous pressure (24.1 ± 5.3 vs. 27.6 ± 5.5; P = 0.001) , lower HVPG (15.3 ± 3.8 vs. 18.0 ± 4.8; P = 0.003) and lower PPG (18.0 ± 3.7 vs. 20.0 ± 3.4; P = 0.005). HVPG (AUC = 0.82; P = 0.002) and PPG (AUC = 0.72;P = 0.027) had promising prognostic value among NASH cirrhosis patients. The optimal threshold of HVPG and PPG for predicting rebleeding in NASH cirrhosis was 17 mmHg and 20 mmHg. At multivariate analysis, an HVPG ≥17 mmHg was a significant predictor of variceal bleeding (HR 9.40; 95% CI 1.85-47.70; P = 0.007). Conclusions Patients with NASH cirrhosis had lower HVPG and lower PPG than those with HBV cirrhosis. However, the prevalence of rebleeding was similar between two groups. HVPG measurement is still an accurate way to assess the risk of variceal rebleeding in NASH cirrhosis.

Background and aimsHepatic venous pressure gradient (HVPG) has a strong predictive value for variceal rebleeding in cirrhotic patients, but the accuracy of HVPG may be compromised in nonalcoholic steatohepatitis (NASH) cirrhosis. This study aimed to evaluate the accuracy of HVPG and portal pressure gradient (PPG) for predicting rebleeding in NASH cirrhosis after acute variceal bleeding.Patients and methodsThirty-eight NASH cirrhosis patients and 82 hepatitis B virus (HBV) cirrhosis patients with acute variceal bleeding were included in this study. All patients recived transjugular intrahepatic portalsystemic shunt (TIPS). The prognostic value of HVPG and PPG for variceal rebleeding was evaluated.ResultsCompared with HBV cirrhosis, NASH cirrhosis demonstrated a lower HVPG (15.3 ± 3.8 vs. 18.0 ± 4.8; p = 0.003) and lower PPG (18.0 ± 3.7 vs. 20.0 ± 3.4; p = 0.005). HVPG (AUC = 0.82; p = 0.002) and PPG (AUC = 0.72; p = 0.027) had promising prognostic value among NASH cirrhosis patients. The optimal threshold of HVPG and PPG for predicting rebleeding in NASH cirrhosis was 17 mmHg and 20 mmHg. At multivariate analysis, HVPG ≥17 mmHg was a significant predictor of variceal rebleeding (HR 9.40; 95% CI 1.85–47.70; p = 0.007).ConclusionIn the patients with cirrhosis and vairceal bleeding, the levels of HVPG and PPG were found to be low in NASH cirrhosis than HBV cirrhosis. However, the prevalence of rebleeding was similar between two groups. HVPG measurement is still an accurate way to assess the risk of variceal rebleeding in NASH cirrhosis.

Background & AimsHepatic venous pressure gradient (HVPG) has a strong predictive value for variceal rebleeding in cirrhotic patients, but the accuracy of an HVPG may be compromised in nonalcoholic steatohepatitis (NASH) cirrhosis. This study aimed to evaluate the accuracy of an HVPG for predicting rebleeding in NASH cirrhosis after initial variceal bleeding.Patients and MethodsThirty-eight NASH cirrhosis patients and 82 hepatitis B virus (HBV) cirrhosis patients who experienced variceal bleeding for the first time were included in this study. We compared the HVPG levels in NASH cirrhosis and HBV cirrhosis. The prognostic value of an HVPG for variceal rebleeding was evaluated.ResultsCompared with HBV cirrhosis, NASH cirrhosis demonstrated a lower portal pressure (26.3 ± 6.1 vs. 30.1 ± 4.7; P <0.001), lower wedge hepatic venous pressure (24.1 ± 5.3 vs. 27.6 ± 5.5; P = 0.001) and lower HVPG (15.3 ± 3.8 vs. 18.0 ± 4.8; P = 0.003). HVPG was proven to have promising prognostic value among NASH cirrhosis patients (AUC = 0.82; P = 0.002). The optimal baseline HVPG threshold for predicting rebleeding in NASH cirrhosis was 17 mmHg. Multivariate analysis also indicated that an HVPG ≥17 mmHg was a significant predictor of variceal bleeding (HR 9.40; 95% CI 1.85-47.70; P = 0.007).ConclusionsPatients with NASH cirrhosis had lower HVPG than those with HBV cirrhosis. However, the prevalence of rebleeding was similar between the two groups. HVPG measurement is still an accurate way to assess the risk of variceal rebleeding in NASH cirrhosis.