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April 12, 2026Clinical Hemorheology and Microcirculation0 citations

Accuracy and influencing factors of hepatic venous pressure gradient, spleen stiffness and liver stiffness in the detection of portal hypertension with liver cirrhosis

Key Points

To evaluate the effectiveness of hepatic venous pressure gradient, spleen stiffness, and liver stiffness in detecting portal hypertension in liver cirrhosis patients.
Measured hepatic venous pressure gradient (HVPG), spleen stiffness (SS), and liver stiffness (LS) in 104 cirrhosis patients.
Analyzed correlations between measures and portal pressure using statistical tests appropriate for data distribution.
Evaluated diagnostic performance using receiver operating characteristic (ROC) curve analysis.
Performed multiple linear regression to identify independent factors affecting HVPG, SS, and LS.
HVPG and SS showed significant correlation with portal pressure gradient (PPG), while LS did not.
HVPG areas under the ROC curve were 0.983, 0.875, and 0.680 for PPG thresholds of 12, 20, and 25 mmHg respectively.
SS areas under the ROC curve were 0.764, 0.922, and 0.700 for the same PPG thresholds.
Factors significantly linked to HVPG included AST, total bilirubin, and prior bleeding; those linked to SS included WBC count and MELD-Na score.

Abstract

PurposeTo assess the accuracy of hepatic venous pressure gradient (HVPG), spleen stiffness (SS) and liver stiffness (LS) for detecting portal hypertension (PH).MethodsWe measured HVPG, SS, LS and portal pressure gradient (PPG) in 104 patients with liver cirrhosis from April 2019 to April 2024. Correlations between these parameters and PH were analyzed using Pearson correlation or Spearman's rank correlation test appropriate. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis. Multiple linear regression analysis was to identify factors independently associated with HVPG, SS and LS.ResultsHVPG and SS were significantly correlated with PPG (p < 0.005), whereas LS showed no significant correlation with PPG (p = 0.532). For prediction of PH defined by PPG≥12, 20 and 25 mmHg, areas under the ROC curve (AUC) of HVPG were 0.983, 0.875 and 0.680, and the AUC of SS were 0.764, 0.922 and 0.700, respectively. Multiple linear regression analysis showed that factors independently associated with HVPG included aspartate aminotransferase (AST), total bilirubin (TBIL) and previous bleeding, while those associated with SS were white blood cell count (WBC) and Model for End-Stage Liver Disease-Sodium (MELD-Na) score.ConclusionHVPG and SS had favorable diagnostic performance for identifying PH in patients with liver cirrhosis.

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