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Measurement of hepatic venous pressure gradient (HVPG) is currently widely adopted
to provide an estimate of portal pressure gradient (PPG) in the diagnosis and treatment
of portal hypertension associated with liver cirrhosis. Despite the well-documented
clinical utility of HVPG, it remains poorly understood how the relationship between
HVPG and PPG is affected by factors involved in the pathogenesis and progression of
cirrhosis. In the study, a computational model of the hepatic circulation calibrated
to in vivo data was developed to simulate the procedure of HVPG measurement and quantitatively
investigate the error of HVPG relative to PPG under various pathophysiological conditions.
Obtained results confirmed the clinical consensus that HVPG is applicable to the assessment
of portal hypertension caused by increased vascular resistance located primarily at
the sinusoidal and postsinusoidal sites rather than at the presinusoidal site. On
the other hand, our study demonstrated that the accuracy of HVPG measurement was influenced
by many factors related to hepatic hemodynamics even in the case of sinusoidal portal
hypertension. For instance, varying presinusoidal portal vascular resistance significantly
altered the difference between HVPG and PPG, while an enhancement in portosystemic
collateral flow tended to improve the accuracy of HVPG measurement. Moreover, it was
found that presinusoidal and postsinusoidal vascular resistances interfered with each
other with respect to their influence on HVPG measurement. These findings suggest
that one should take into account patient-specific pathological conditions in order
to achieve a better understanding and utilization of HVPG in the clinical practice.