PLOS ONE Medicine&Health

Hepatic venous pressure gradient in patients with (compensated and decompensated) advanced chronic liver disease – A comparison of metabolic dysfunction-associated steatotic liver disease with alcohol-associated liver disease: A retrospective view

by Ĺubomír Skladaný, Daniela Žilinčanová, Michal Žilinčan, Stanislav Okapec, Filip Danček, Svetlana Adamcová-Selčanová, Michal Kukla, Tomáš Koller

Background and aims

Hepatic venous pressure gradient (HVPG) is a strong surrogate of severity and outcome but its relative prognostic value in metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD) is yet to be clarified. We compared HVPG in MASLD with ALD and other etiologies according to cirrhosis complications.

Patients and methods

In our cirrhosis registry RH7, we identified patients with data on HVPG and scrutinized them against the etiology of advanced chronic liver disease (ACLD) (MASLD, ALD, Other) and specific complications of ACLD such as variceal bleeding or ascites. We excluded patients with advanced malignancies and less than 6 months of follow-up.

Results

We enrolled 220 patients with ALD, MASLD, and Other etiology in 128, 52, and 40 cases, respectively; te median age was 57, 60, and 52 years (P = 0.09); the proportion of females was 31, 67, and 55%, respectively (P 10 mmHg).

Conclusion

In our cirrhosis registry study of hospitalized patients with ACLD, baseline HVPG measured for accepted indications differed according to the etiology of dACLD: patients with ALD had the highest values followed by MASLD and Other etiologies. Importantly, when looked at from the point of view of complications, the treshold for clinically significant portal hypertension remained fixed at the level recommended by BAVENO Consensus - 10 mm Hg irrespective of etiology.