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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

[Preliminary study on hemodynamics in post hepatitic cirrhotic patients with portal hypertension (PCPH) using Doppler

X F Zhang1

  • 1Second Clinical College, China Medical University, Shenyang.

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|April 1, 1993
PubMed

Insights

This study reveals that patients with portal cavernous transformation of the portal vein (PCPH) exhibit a hyperdynamic circulatory state, primarily from the spleen. Surgical interventions like portasystemic shunts effectively reduce this hyperdynamic state.

Area of Science:

  • Cardiovascular Medicine
  • Gastroenterology
  • Medical Imaging

Background:

  • Portal cavernous transformation of the portal vein (PCPH) is a rare condition characterized by venous obstruction.
  • Patients with PCPH often present with a hyperdynamic circulatory state, but its origins and hemodynamic characteristics require further elucidation.

Purpose of the Study:

  • To investigate the hemodynamic alterations in patients with PCPH.
  • To establish Doppler ultrasound-based diagnostic criteria for PCPH.
  • To evaluate the impact of surgical interventions on the hyperdynamic state in PCPH.

Main Methods:

  • Doppler ultrasound was employed to assess hemodynamics in healthy volunteers and patients with PCPH (pre- and post-operatively).
  • Key hemodynamic parameters including splenic vein cross-sectional area, portal vein congestion index (CI), and splenic vein flow/portal vein flow (SVF/PVF) ratio were measured.
  • Patients underwent either portasystemic shunt or porta-azygous devascularization procedures.

Main Results:

  • Patients with PCPH demonstrated a systemic hyperdynamic circulatory state, predominantly driven by a hyperdynamic splenic circulation.
  • Diagnostic criteria for PCPH were established: CI > 0.1 cm/s, splenic vein cross-sectional area > 0.6 cm², and SVF/PVF > 50%.
  • Both portasystemic shunt and porta-azygous devascularization significantly reduced the hyperdynamic circulatory state.

Conclusions:

  • PCPH is associated with a distinct hyperdynamic circulatory state originating from the spleen.
  • Specific Doppler ultrasound-derived hemodynamic parameters serve as reliable diagnostic criteria for PCPH.
  • Surgical management, including shunting and devascularization, effectively mitigates the hyperdynamic circulatory state in PCPH.

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