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Portal Hypertension in Nonalcoholic Fatty Liver Disease: Challenges and Paradigms

Journal of Clinical and Translational Hepatology 2023年第5期11卷 1201-1211页

作者： Emilie K.Mitten Piero Portincasa György Baffy Division of Gastroenterology Department of MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Division of Internal Medicine and Department of Precision and Regenerative Medicine and Ionian Area University‘Aldo Moro’Medical SchoolBariItaly Division of Gastroenterology Hepatology and EndoscopyDepartment of MedicineBrigham and Women’s HospitalHarvard Medical SchoolBostonMAUSA Section of Gastroenterology Department of MedicineVA Boston Healthcare SystemBostonMAUSA

Portal hypertension in cirrhosis is defined as an increase in the portal pressure gradient(PPG)between the portal and hepatic veins and is traditionally estimated by the hepatic venous pressure gradient(HVPG),which is the difference in pressure between the free-floating and wedged positions of a balloon catheter in the hepatic *** convention,􀀫HVPG≥10mmHg indicates clinically significant portal hypertension,which is associated with adverse clinical *** fatty liver disease(NAFLD)is a common disorder with a heterogeneous clinical course,which includes the development of portal *** is increasing evidence that portal hypertension in NAFLD deserves special ***,elevated PPG often precedes fibrosis in NAFLD,suggesting a bidirectional relationship between these pathological ***,HVPG underestimates PPG in NAFLD,suggesting that portal hypertension is more prevalent in this condition than currently ***,cellular mechanoresponses generated early in the pathogenesis of NAFLD provide a mechanistic explanation for the pressurefibrosis ***,a better understanding of liver mechanobiology in NAFLD may aid in the development of novel pharmaceutical targets for prevention and management of this disease.

关键词： sinusoidal microcirculation Hepatic vascular resistance Portal venous pressure Hepatic venous pressure gradient Mechanobiology Mechanotransduction

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