Chen Rufeng, Liu Yaozu, Ma Li, Zhang Wen, Zhou Yongjie, Yang Minjie, Yu Jiaze, Yan Zhiping, Ma Jingqin, Luo Jianjun
Shanghai Institution of Medical Imaging, Fudan University, Shanghai, China.
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
BMC Gastroenterol. 2025 Apr 10;25(1):241. doi: 10.1186/s12876-025-03816-z.
To evaluate the correlation and consistency between hepatic venous pressure gradient(F-HVPG) calculated as the wedged hepatic venous pressure (WHVP) minus free hepatic venous pressure (FHVP), I-HVPG calculated as WHVP minus inferior vena cava pressure (IVCP) in the hepatic segment, and portal pressure gradient (PPG).
Data were collected from 112 patients with portal hypertension undergoing transjugular intrahepatic portosystemic shunt (TIPS) along with HVPG measurement. FHVP, IVCP, WHVP, and portal venous pressure (PVP) were collected intraoperatively. Pearson's correlation and Bland-Altman method were used to assess correlation and consistency.
A total of 112 patients were retrospectively collected. The correlation coefficient (r) values (p < 0.001) between FHVP and IVCP, WHVP and PVP, F-HVPG and I-HVPG, F-HVPG and PPG, I-HVPG and PPG were 0.835, 0.717, 0.946, 0.667 and 0.698, respectively; the determination coefficient (R) values were 0.697, 0.514, 0.895, 0.445 and 0.487, respectively. Bland-Altman plots showed that F-HVPG and I-HVPG had the narrowest 95% limits of agreement. Among patients with FHVP-IVCP > 2 mmHg, the (r) values (p < 0.05) between F-HVPG and I-HVPG, F-HVPG and PPG, I-HVPG and PPG were 0.907, 0.648 and 0.807, respectively; the (R) values were 0.822, 0.420 and 0.651, respectively. Bland-Altman plots showed that I-HVPG had the narrower 95% limits of agreement with PPG.
F-HVPG and I-HVPG demonstrated high correlation and consistency. I-HVPG consistently correlates more closely with PPG than F-HVPG, both in the overall cohort and in patients with FHVP-IVCP > 2 mmHg. These results suggest that I-HVPG may serve as a more reliable alternative. Due to the significant underestimation of the PPG, HVPG measurement should not be used to exclude patients from a TIPS intervention.
评估以肝静脉楔压（WHVP）减去游离肝静脉压（FHVP）计算所得的肝静脉压力梯度（F-HVPG）、以肝段下腔静脉压（IVCP）减去WHVP计算所得的I-HVPG与门静脉压力梯度（PPG）之间的相关性和一致性。
收集112例接受经颈静脉肝内门体分流术（TIPS）并同时测量肝静脉压力梯度（HVPG）的门静脉高压患者的数据。术中收集FHVP、IVCP、WHVP和门静脉压力（PVP）。采用Pearson相关性分析和Bland-Altman方法评估相关性和一致性。
共回顾性收集112例患者。FHVP与IVCP、WHVP与PVP、F-HVPG与I-HVPG、F-HVPG与PPG、I-HVPG与PPG之间的相关系数（r）值（p＜0.001）分别为0.835、0.717、0.946、0.667和0.698；决定系数（R）值分别为0.697、0.514、0.895、0.445和0.487。Bland-Altman图显示F-HVPG和I-HVPG的95%一致性界限最窄。在FHVP-IVCP＞2 mmHg的患者中，F-HVPG与I-HVPG、F-HVPG与PPG、I-HVPG与PPG之间的（r）值（p＜0.05）分别为0.907、0.648和0.807；（R）值分别为0.822、0.420和0.651。Bland-Altman图显示I-HVPG与PPG的95%一致性界限更窄。
F-HVPG和I-HVPG显示出高度的相关性和一致性。在总体队列以及FHVP-IVCP＞2 mmHg的患者中，I-HVPG与PPG的相关性始终比F-HVPG更紧密。这些结果表明I-HVPG可能是一种更可靠的替代指标。由于PPG存在显著低估，不应使用HVPG测量来排除患者接受TIPS干预。
