Correlation of endoscopic ultrasound-guided portal pressure gradient measurements with hepatic venous pressure gradient: a prospective study.

IF 11.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Endoscopy Pub Date : 2025-01-01 Epub Date: 2024-07-18 DOI:10.1055/a-2369-0759
Belén Martinez-Moreno, Juan Martínez Martínez, Iván Herrera, Lucía Guilabert, María Rodríguez-Soler, Pablo Bellot, Cayetano Miralles, Sonia Pascual, Javier Irúrzun, Pedro Zapater, José María Palazón-Azorín, Vicente Gil Guillén, Rodrigo Jover, José R Aparicio
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Abstract

Background: Hepatic venous portal gradient (HVPG) measurement remains the gold standard for estimating portal pressure gradient (PPG). This study aimed to evaluate the correlation between endoscopic ultrasound (EUS)-guided PPG and HVPG in patients with chronic portal hypertension.

Methods: Patients with chronic portal hypertension in whom HVPG assessment was clinically indicated were invited to undergo transjugular HVPG and EUS-PPG with a 22-G needle in separate sessions for comparison. Intraclass correlation coefficient (ICC) and the Bland-Altman method were used to evaluate the agreement between techniques.

Results: 33 patients were included. No significant differences in technical success were observed: EUS-PPG (31/33, 93.9%) vs. HVPG (31/33, 93.9%). Overall, 30 patients who underwent successful EUS-PPG and HVPG were analyzed. Correlation between the two techniques showed an ICC of 0.82 (0.65-0.91). Four patients had major discrepancies (≥5 mmHg) between HVPG and EUS-PPG. No significant differences in adverse events were observed.

Conclusions: The correlation between EUS-PPG and HVPG was almost perfect. EUS-PPG could be a safe and reliable method for direct PPG measurement in patients with cirrhosis and a valid alternative to HVPG.

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EUS 引导下的门静脉压力梯度测量与肝静脉压力梯度的相关性:一项前瞻性研究。
背景和目的:肝静脉门静脉压力梯度(HVPG)测量仍是估算门静脉压力梯度(PPG)的金标准。目的:评估慢性门静脉高压症患者在 EUS 引导下的门静脉压力梯度(EUS-PPG)与 HVPG 之间的相关性:邀请有 HVPG 评估临床指征的慢性门静脉高压症患者分别进行经颈静脉 HVPG 和使用 22G 穿刺针的 EUS-PPG 评估,以进行比较。采用类内相关系数 (ICC) 和 Bland-Altman 法评估两种技术之间的一致性:结果:共纳入 33 名患者。技术成功率无明显差异:EUS-PPG (31/33, 93.9%) vs. HVPG (31/33, 93.9%).对成功接受 EUS-PPG 和 HVPG 的 30 例患者进行了分析。两种技术之间的相关性显示 ICC:0.82(0.65-0.91).四名患者的 HVPG 和 EUS-PPG 差异较大(≥ 5 mmHg)。不良反应方面无明显差异:结论:EUS-PPG 与 HVPG 几乎完全相关。结论:EUS-PPG 与 HVPG 的相关性几乎完美,EUS-PPG 是肝硬化患者直接测量 PPG 的一种安全可靠的方法,也是 HVPG 的有效替代方法。NCT05689268。
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来源期刊
Endoscopy
Endoscopy 医学-外科
CiteScore
5.80
自引率
11.80%
发文量
1401
审稿时长
2 months
期刊介绍: Endoscopy is a leading journal covering the latest technologies and global advancements in gastrointestinal endoscopy. With guidance from an international editorial board, it delivers high-quality content catering to the needs of endoscopists, surgeons, clinicians, and researchers worldwide. Publishing 12 issues each year, Endoscopy offers top-quality review articles, original contributions, prospective studies, surveys of diagnostic and therapeutic advances, and comprehensive coverage of key national and international meetings. Additionally, articles often include supplementary online video content.
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