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Portal vein pulsatility ratio and heart failure
D Catalano1, G Caruso, S DiFazzio
1Istituto di Medicina Interna e Terapia Medica, Università di Catania, Italy.
Journal of Clinical Ultrasound : JCU
|February 25, 1998
Summary
Heart failure impacts portal vein blood flow, with reduced pulsatility ratio (PR) indicating worsening cardiac function. This Doppler measurement offers a reliable, noninvasive sign for assessing heart failure severity.
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Heart diseases can significantly alter liver function, including volume, morphology, and circulation.
- Doppler pulsatility of the portal vein and its pulsatility ratio (PR) are linked to right atrial pressure and heart failure severity (New York Heart Association class).
Purpose of the Study:
- To investigate the relationship between liver and spleen dimensions and blood flow in portal and hepatic veins.
- To compare noninvasive Doppler sonography measurements with echocardiographic data in heart failure patients.
Main Methods:
- 87 inpatients with heart failure underwent duplex Doppler sonography of the heart and portal/hepatic veins.
- Patients were categorized by heart failure severity (NYHA class I-II vs. III-IV).
Main Results:
- Severe heart failure (NYHA class III-IV) correlated with reduced portal vein mean velocity, increased hepatic vein diameter, and decreased portal vein PR.
- Portal vein PR showed significant correlations with left ventricular ejection fraction, shortening fraction, and various cardiac chamber dimensions.
- Hepatic vein dilatation was associated with increased left ventricular volumes and reduced systolic function.
Conclusions:
- Portal blood flow alterations, particularly the pulsatility pattern of the portal vein, better reflect cardiac failure progression than morphologic measurements.
- Portal vein pulsatility ratio (PR) serves as a dependable, noninvasive adjunctive marker for heart failure assessment.