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ORIGINAL ARTICLES  
CMH 2012 December;18:391-396.
Published online 2012 December 24. doi:http://dx.doi.org/10.3350/cmh.2012.18.4.391
Copyright © 2012 The Korean Association for the Study of the Liver
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Relationship between the hepatic venous pressure gradient and first variceal hemorrhage in patients with cirrhosis: a multicenter retrospective study in Korea
Jin Nyoung Kim1*, Kyoung Min Sohn2*, Moon Young Kim3, Ki Tae Suk2, Soung Won Jeong1, Ho Eun Jung1, Sae Hwan Lee4, Sang Gyune Kim5, Jae Young Jang1, Young Seok Kim5, Soon Koo Baik3, Hong Soo Kim4, Dong Joon Kim2, and Boo Sung Kim1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul; 2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon; 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju; 4Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon; 5Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
Corresponding Author: Soon Koo Baik ,Tel: +82-33-741-1223, Fax: +82-33-741-1228, Email: baiksk@yonsei.ac.kr
ABSTRACT
Background/Aims: Variceal hemorrhage is one of the major complications of cirrhosis and is associated with significant mortality and morbidity. The development of gastroesophageal varices and variceal hemorrhage is the most direct consequence of portal hypertension. Correlations between the hepatic venous pressure gradient (HVPG) and first variceal hemorrhage were examined.
Methods: Patients with cirrhosis who underwent HVPG measurement between July 2009 and September 2010 were enrolled (n=535). All patients underwent esophagogastroduodenoscopy to enable the evaluation of gastroesophageal varices.
Results: The HVPG for all patients was 16.467.05 mmHg (meanSD), and was significantly higher among those with first variceal hemorrhage than in those without it. The HVPG was significantly correlated with both Child-Turcotte-Pugh (r=0.488, P<0.001) and Model for End-stage Liver Disease (r=0.478, P<0.001) scores. An HVPG value of 11 mmHg was predictive of first variceal hemorrhage with a sensitivity of 92.4% and a specificity of 27.7%.
Conclusions: The HVPG was higher in patients with first variceal hemorrhage than in those without it.
Keywords: Hepatic venous pressure gradient (HVPG); Variceal hemorrhage
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