Abstract：
:Hepatic venous pressure gradient (HVPG) is a hemodynamic index widely used for evaluating the severity of portal hypertension. Theoretically, HVPG can be measured in any of the three major (i.e., right, middle and left) hepatic veins (HVs); however, it remains unclear whether HVPGs measured in different HVs are exchangeable, and if not, what factors cause inter-HV HVPG differences? In consideration of the potential limitations of invasive in vivo measurements, we employed a computational model implemented in conjunction with stochastic parameter sampling to simulate and compare HVPG measurements in multiple HVs under various sinusoidal portal hypertensive conditions. Results demonstrated that HVPGs measured in the right and middle HVs were basically exchangeable, whereas those in the left HV were relatively lower due primarily to the smaller proportion of hepatic venous flow through the left HV compared with that through the right or middle HV. Moreover, it was found that hepatic vein-to-vein shunts (HVVS) led to a marked augmentation of inter-HV HVPG differences and significant underestimation of portal pressure gradient with HVPG. These findings suggest that understanding the distribution of hepatic venous flow and status of HVVS is essential for selecting a proper HV for implementing HVPG measurement in clinical practice.
journal_name
Med Eng Physjournal_title
Medical engineering & physicsauthors
Wang T,Liang F,Li L,Zhang W,Wang G,Wang J,Zhang C,Qi Xdoi
10.1016/j.medengphy.2020.07.022subject
Has Abstractpub_date
2020-10-01 00:00:00pages
28-35eissn
1350-4533issn
1873-4030pii
S1350-4533(20)30120-Xjournal_volume
84pub_type
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