Hepatic Venous Pressure Gradient (HVPG) and Portal Hypertension

 

The measurement of the hepatic venous pressure gradient is performed by catheterization of the hepatic vein.

 

hepatic venous pressure gradient in mm Hg =

= (wedged hepatic venous pressure) - (free hepatic venous pressure)

 

where:

• The wedge hepatic venous pressure indicates the sinusoidal pressure.

 

Interpretation:

• The normal HVPG is < 5 mm Hg.

• The goal of decompressive therapy is to keep the HVPG < 12 mm Hg since this reduces the chance of variceal bleeding.

 

HVPG	Interpretation
<= 5 mm Hg	normal
> 5 mm Hg	portal hypertension
> 12 mm Hg	esophageal varices likely