Abstract：
Centers for the research of patients with pulmonary hypertension (PH) usually perform right cardiac catheterization (RHC) to document this hemodynamic condition; traditionally, the procedure is performed by the interventional cardiologist, while the interventional radiologist generally conducts the study of hepatic hemodynamics. In our center, where the leading cause of catheterization of the hepatic veins is orthotopic liver transplantation, the cardio-pulmonologist performs the procedure to diagnose the possibility of porto-pulmonary hypertension and its implications. Routine measurement of the hepatic venous pressure gradient (HVPG) during RHC is not recommended but is performed to confirm the diagnosis of portal hypertension (PoH). Our objective in this review was to graphically describe the technique of hemodynamic recording of suprahepatic veins in patients with chronic liver disease and PoH who are in liver transplant protocol. The concepts included in this manuscript are measuring portal pressure, the definition of the hepatic venous pressure gradient (HVPG), procedures for a correct measurement of the HVPG, techniques associated with a suprahepatic vein catheterization, contraindications, and complications of HVPG, and clinical applications of HVPG. Clinically significant PoH is defined as an increase in GPVH ≥10 mmHg. HVPG measurement is currently the best available method for assessing the presence and severity of PoH. The RHC is the standard gold method for diagnosing PoPH that confirms its existence and provides additional data to exclude other causes of PAH in liver transplant candidates.
摘要：
肺动脉高压（PH）患者的研究中心通常进行右心导管插入术（RHC）以记录这种血液动力学状况；传统上，该程序由介入心脏病学家执行，而介入放射科医生通常进行肝脏血流动力学的研究。在我们的中心,肝静脉插管的主要原因是原位肝移植，心肺科医师执行该程序以诊断肺-肺动脉高压的可能性及其影响。不建议在RHC期间对肝静脉压力梯度（HVPG）进行常规测量，但要确认门静脉高压症（PoH）的诊断。我们在这篇综述中的目的是以图形方式描述接受肝移植方案的慢性肝病和PoH患者的肝上静脉血流动力学记录技术。本手稿中包含的概念是测量门静脉压力，肝静脉压力梯度（HVPG）的定义，正确测量HVPG的程序，与肝上静脉导管插入术相关的技术，禁忌症,和HVPG的并发症，HVPG的临床应用。临床显著的PoH定义为GPVH的增加≥10mmHg。HVPG测量是目前评估PoH的存在和严重程度的最佳可用方法。RHC是诊断PoPH的标准金方法，可确认其存在，并提供其他数据以排除肝移植候选物中PAH的其他原因。
