Portal Venous Remodeling Determines the Pattern of Cirrhosis Decompensation: A Systems Analysis

Abstract

As liver disease progresses, scarring results in worsening hemodynamics ultimately culminating in portal hypertension. This process has classically been quantified through the portosystemic pressure gradient (PSG), which is clinically estimated by hepatic venous pressure gradient (HVPG); however, PSG alone does not predict a given patient's clinical trajectory regarding the Baveno stage of cirrhosis.

We hypothesize that a patient's PSG sensitivity to venous remodeling could explain disparate disease trajectories.

Keywords

• computational modeling
• portal hypertension
• hemodynamics
• cirrhosis
• natural history