Wedged hepatic venous pressure adequately reflects portal pressure in hepatitis C virus-related cirrhosis

Wedged hepatic venous pressure (WHVP) is equivalent to portal venous pressu re in patients with alcoholic liver diseases. However, it may underestimate portal pressure in nonalcoholics, which is important because hepatitis C v irus (HCV) infection is a frequent cause of chronic liver disease. We inves tigated the agreement between directly measured portal pressure and WHVP in alcoholic and HCV-related liver diseases. Seventy-one patients with liver disease resulting from HCV infection (n = 32), alcohol (n = 25;), or both ( n = 14) underwent simultaneous measurements of WHVP (by hepatic vein cathet erization) and portal pressure (by direct puncture). In 9 patients, measure ments were repeated 20 minutes after acute iv propranolol administration. W HVP showed an excellent agreement with portal pressure in patients with cir rhosis resulting from either HCV, alcohol or both (intraclass correlation c oefficient: 0.94, 0.93, and 0.97, respectively; P < .001), A discrepancy of greater than or equal to 5 mm Hg was observed in 7 cases. WHVP underestima ted portal pressure in only I case and exceeded portal pressure by greater than or equal to 5 mm Hg in 6 patients, The WHVP response to propranolol cl osely and significantly correlated with changes in portal pressure (intracl ass correlation coefficient: 0.87; P < .004). The simple and safe measureme nt of WHVP accurately reflects portal pressure in alcoholic and HCV-related liver disease. This technique also allows us to accurately assess the port al pressure response to propranolol in both alcoholic and HCV-related cirrh osis.