Portal hypertension and portal hypertensive gastropathy in patients with liver cirrhosis: a haemodynamic study

Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

“…Iwao et al [28] reported that patients with severe PHG had elevated HVPG, high hepatic sinusoidal resistance, and low hepatic blood PHG had significantly higher HVPG (15.6 ± 4.6 mmHg) than patients with mild PHG (10.7 ± 4.1 mmHg) or no PHG (4.9 ± 1.7 mmHg) (P < 0.001). Merkel et al [36] similarly reported in a small study that HVPG was significantly higher in patients with severe PHG as compared to mild or no PHG. Primignani et al [34] confirmed the correlation of PHG with severity of portal hypertension, by correlating PHG with presence and size of esophageal varices.…”

“…Merkel et al [36] reported that the severity of PHG was correlated with the severity of portal hypertension as determined by HVPG, but this correlation was significant only for severe PHG (HVPG . In a prospective study of 331 cirrhotic patients, Kim et al [57] found that patients with severe [3] Portal hypertension 127 65 (51%) 37 (29%) 28 (22%) Sarin et al [5] Portal hypertension 136 10 (7%) DeWeert et al [6] Non-alcoholic liver disease 81 23 (28%) Not reported Not reported McCormick et al [7] Portal hypertension 93 endoscopies in 74 patients 85 endoscopies (91%) 6 (6%), moderate 61 (66%) 18 (19%)…”

“…Portal hypertension: Most studies show that the frequency and severity of PHG is strongly correlated with the severity of portal hypertension, as indicated by multiple parameters, including hepatic venous pressure gradient (HVPG) [36,57] , esophageal intravariceal pressure [29] , and presence or size of esophageal varices [34,42,57,62,73] . Merkel et al [36] reported that the severity of PHG was correlated with the severity of portal hypertension as determined by HVPG, but this correlation was significant only for severe PHG (HVPG .…”

“…Primignani et al [34] confirmed the correlation of PHG with severity of portal hypertension, by correlating PHG with presence and size of esophageal varices. Sacchetti et al [24] Cirrhosis 142 38 (27%) 28 (20%) 10 (7%) D'Amico et al [25] Cirrhosis 212 130 (61%) 110 (52%) 20 (9%) Calès et al [26] Cirrhosis 100 98 (98%) 57 (57%) 41 (41%) Rabinovitz et al [27] Cirrhosis 510 (43%) Not reported Not reported Iwao et al [28] Cirrhosis 47 32 (68%) 15 (32%) 17 (36%) Taranto et al [29] Cirrhosis 394 317 (80.5%) Not reported Not reported Gupta et al [30] Cirrhosis 230 (61%) (52%) (9%) Iwao et al [31] Cirrhosis 476 254 (53%) 208 (43%) 46 (9%) Carpinelli et al [32] Cirrhosis 566 362 (64%) 192 (34%) 170 (30%) Zaman et al [33] Cirrhosis 120 74 (62%) 47 (39%) 27 (23%) Primignani et al [34] Cirrhosis 373 299 (80%) 127 (34%) 172 (46%) Chaves et al [35] Cirrhosis vs schistosomiasis 43 18 (81%) vs 7 (33%) Not reported Not reported Merkel et al [36] Cirrhosis 62 49 (79%) 29 (46%) 20 (32%) Merli et al [37] Cirrhosis, with mild portal hypertension 222 48 (21%) 43 (19%) 5 (2%) Ito et al [38] Cirrhosis 47 13 (27%) 10 (21%) 3 (6%) De Palma et al [39] Cirrhosis 37 23 (62%) Not reported Not reported Menchén et al [40] Cirrhosis 549 353 (64%) 275 (50%) 77 (14%) Yüksel et al [41] Cirrhosis 114 total 76 (66%) 38 (33%) 38 (33%) Fontana et al [42] Cirrhosis or bridging fibrosis from hepatitis C 1016 374 (37%) 345 (34%) 29 (3%) Bresci et al [43] Cirrhosis 85 36 (42%) Not reported Not reported Akatsu et al [44] End stage liver disease 29 19 (65.5%) 18 (62.1%) 1 (3.4%) Zardi et al [45] Cirrhosis 266 84 (31%) Not reported Not reported Barakat et al [46] Cirrhosis with portal hypertensive duodenopathy 105 105 (100%) 17 (16.2%) 88 (83.8%) Bellis et al [47] Cirrhosis 59 44 (76%) 16 (27%) 28 (47%) Gravante et al [48] Liver transplant candidates with cirrhosis 80 41 (51.2%) Not reported Not reported Canlas et al [49] [58] Cirrhosis 611 448 (73.3%) 37.3% 36% Abbasi et al [59] Cirrhosis 102 87 (85%) Not reported Not reported Ahmed et al …”

“…Contrariwise, a minority of studies found no correlation between liver disease severity, as determined by Child-Pugh stage, and presence or severity of PHG [34,36,40,47,54,62,70,79] . For example, Primignani et al [34] reported the prevalence of severe PHG was lowest in ChildPugh stage C. In the NIEC study, patients with ChildPugh stage B had a higher prevalence of PHG than patients with stages A or C. Zardi et al [67] reported no significant differences in Child-Pugh stage or in MELD score among cirrhotic patients with vs without PHG.…”