Correlation of hepatic venous pressure gradient with variceal bleeding, size of esophageal varices, etiology, ascites and degree of liver dysfunction in cirrhosis of liver.

An elevated hepatic venous pressure gradient (HVPG) has been associated with risk of variceal bleeding, and outcome and survival after variceal bleeding. In this pilot study, we measured HVPG in 40 patients with liver cirrhosis and studied its relationship with etiology of liver disease, esophageal variceal size, history of variceal bleeding or ascites, biochemical liver tests and Child-Pugh class. There was no procedurerelated complication. The mean (SD) HVPG was similar in patients who had history of variceal bleeding as compared to those who did not (15.4 [2.8] mmHg vs. 13.9 [2.7] mmHg, p=0.1); HVPG had no significant association with etiology of cirrhosis (p=0.4). HVPG levels were significantly higher in patients with larger esophageal varices (grade III/IV vs. I/II: 15.2 [2.7] mmHg vs.13.1 [2.8] mmHg, p=0.04), poorer Child-Pugh class (B or C versus A), and presence of ascites (p=0.04). Thus, HVPG correlated with variceal size, Child-Pugh class, and presence of ascites, but not with variceal bleeding status.

Left ventricular mass and functions in normotensive offspring of hypertensive parents: an echocardiographic study.

OBJECTIVE: Published observations about cardiovascular alterations in normotensive individuals genetically predisposed to develop essential hypertension are conflicting. We tested the hypothesis that abnormalities in left ventricular mass and/or functions may be present in normotensive children of hypertensive parents. METHODS: One hundred normotensive offsprings (6 to 18 year age) of hypertensive parents (OHP) and an equal number of age- and sex-matched normotensive offsprings of normotensive parents (ONP) were studied with 2-dimensionally guided M-mode and Doppler echocardiography for left ventricular (LV) dimensions, mass, and systolic and diastolic functions. RESULTS: Both the groups had similar body mass index and blood pressure levels. LV dimensions and LV mass in OHP were higher than the corresponding values in ONP but the differences were not statistically significant. LV mass in male OHP was higher than in female OHP; LV mass was also higher when the mother rather than father was hypertensive. None of these differences were statistically significant, however. LV systolic functions were normal and identical in the two subject groups. Indices of LV diastolic function (peak early filling velocity and its deceleration time and late filling velocity) were also normal and similar in the two groups. CONCLUSION: We conclude that children with a family history of essential hypertension have modest alterations in LV mass and these alterations might have a genetic basis separate from but possibly co-inherited with the trait of essential hypertension.