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Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
09:37

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

Published on: August 1, 2018

Portal hemodynamics in cirrhotics with portal hypertension using color Doppler velocity profile

J Huang1, X Yin, M Lu

  • 1Department of Hepatobiliary Surgery, First Affiliated Hospital of Sun Yat-Sen University of Medical Sciences, Guangzhou 510080, China. gylumd@public.guangzhou.gd.cn

Chinese Medical Journal
|October 17, 2001
PubMed

Insights

A new technique, color Doppler velocity profile (CDVP), reveals portal hypertension in cirrhotics features elevated vascular resistance and hyperdynamics. An esophageal variceal bleeding (EVB) score derived from CDVP may predict EVB occurrence.

Area of Science:

  • Hepatology and Gastroenterology
  • Medical Imaging and Diagnostics
  • Vascular Physiology

Background:

  • Portal hypertension is a serious complication of cirrhosis, leading to esophageal variceal bleeding (EVB).
  • Accurate assessment of portal hemodynamics is crucial for predicting EVB risk in cirrhotic patients.
  • Existing methods may not fully capture the complex hemodynamic changes associated with portal hypertension.

Purpose of the Study:

  • To evaluate portal hemodynamics in cirrhotics with portal hypertension using color Doppler velocity profile (CDVP).
  • To investigate the correlation between CDVP-derived hemodynamic parameters and the occurrence of esophageal variceal bleeding (EVB).
  • To identify independent predictors of EVB in cirrhotic patients.

Main Methods:

  • Color Doppler velocity profile (CDVP) was used to assess hemodynamics of the portal trunk (PT), right anterior branch (RAB), and splenic vein (SV) in 48 cirrhotics and 35 controls.
  • Key parameters measured included maximum cross-sectional velocity (CS-Vmax), flow volume, congestion index (CI), and flow curve patterns.
  • A stepwise logistic regression model was employed to identify factors associated with EVB.

Main Results:

  • Cirrhotics exhibited significantly lower CS-Vmax in PT and RAB, but higher flow volume and CI in PT, RAB, and SV compared to controls (P < 0.01).
  • Distinct flow patterns were observed in RAB and SV of cirrhotics.
  • Splenic size, degree of esophageal varices (EV), portal hypertensive gastropathy (PHG), and the N value of SV were identified as independent predictors of EVB. An EVB score demonstrated a strong correlation with EVB history.

Conclusions:

  • The cirrhotic portal venous system is characterized by elevated vascular resistance and hyperdynamic flow, primarily driven by increased splenic vein blood flow.
  • The developed EVB score, incorporating hemodynamic and morphological factors, shows promise as a valuable tool for predicting EVB occurrence.
  • CDVP offers a novel approach to characterizing portal hemodynamics and assessing EVB risk in patients with cirrhosis and portal hypertension.
Abstract

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