BackgroundHepatic decompensation in cirrhosis heralds an accelerated course with poor survival. An increase in hepatic venous pressure gradient (HVPG), rather than surrogate tests of liver function, appears to be the sole predictor of decompensation after surgical resection. We propose that hepatic sinusoidal walls become less elastic as cirrhosis progresses. Decompensation signals the development of increased vessel wall rigidity. The pressure-flow characteristics then become subject to Hagen-Poiseuille's law, which applies only to rigid, cylindrical vessels. Thereafter, HVPG rises exponentially (by a factor inversely proportional to the fourth power of the net radius of functional sinusoidal vessels, 1/r4, at any given hepatic blood flow rate. This review attempts to correlate liver stiffness, risk of decompensation and outcomes from hepatocellular carcinoma (HCC) in patients with cirrhosis.
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机译：背景肝硬化的肝功能不全预示着病程加快，生存率低。肝静脉压力梯度（HVPG）的增加，而不是肝功能的替代检查，似乎是手术切除后失代偿的唯一预测因素。我们建议，随着肝硬化的进展，肝窦壁的弹性降低。失代偿信号表明血管壁刚度增加。然后，压力-流量特性将服从哈根-泊乌依耶定律，该定律仅适用于刚性圆柱容器。此后，在任何给定的肝血流量下，HVPG呈指数增长（与功能性正弦血管净半径的四次方1 / r 4 成反比）。僵硬，失代偿的风险以及肝硬化患者的肝细胞癌（HCC）结果。
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