Hemodynamic analysis of portal hypertension in patients with liver cirrhosis

Elbarbary, Aly Aly; El-Bedewy, Mohamed; Elbadry, Amr Arafa

doi:10.4103/1110-1415.145276

Cited by 6 publications

(7 citation statements)

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“…The present result also agrees with the findings of Elbarbary et al [20] The mean ± SD of the hepatic artery resistive index (HARI) of 0.55 ± 0.16 obtained in the present study agrees with Achim et al, [22] that reported a mean value of 0.54 ± 0.06 in 20 healthy subjects of Romanian origin (Caucasian race) using Doppler techniques. The student's t-test comparison of the two results gave a p-value of 0.781 depicting non-significant difference.…”

Section: 3: Impact Of Age Group On Hepaticsupporting

confidence: 93%

“…Again, the similarities in the result of the present study and those of the studies mentioned above could suggest that race does not have strong influence of HAPI parameters. However, there are slight dissimilarities between the value of HAPI obtained in the present study (1.05 ± 0.13) and that by Schneider et al, [25] which reported a lower HAPI value of 0.92 ± 0.1 1981 IJBPAS, October, 2019, 8(10) among 20 apparently healthy Germans and Elbarbary et al, [20] that recorded a higher HAPI value of 1.57 ± 0.064 in 20 apparently healthy adults among Egyptians. No obvious reason could be attributed to these differences except to say that it could be due to the high operator dependability and subjectivity error of ultrasound procedures.…”

Section: Caucasians Of Romanian Origin With Valuescontrasting

confidence: 70%

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Baseline Nomogram of Hepatic Doppler Parameters and Their Relationship With Visceral Adiposity in Abuja, Nigerian

2019

IJBPAS

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Background: Hepatic Doppler sonography gives vital information that helps in early and accurate detection of many hepatic disorders. The absence of local nomograms may have limited the use of these indices in early and accurate detection of the onset of hepatic diseases among Nigerians. No study has shown the relationship that exists between hepatic Doppler parameters and visceral adiposity.Aim: Our aim is to establish baseline values of the portal vein congestive index (PVCI), hepatic artery resistive index (HARI), hepatic artery pulsatility index (HAPI) and hepatic Doppler perfusion index (HDPI) in a given apparently healthy adult Nigerian population and compare these values with those of other races. We also aim at finding the relationship that may exist between these indices and visceral adipose thickness. Materials and Methods:A prospective cross-sectional study with a data capturing sheet was adopted. Diasonics spectra DCN3-2013, Mindray ultrasound machine equipped with Doppler facilities was used. The scan was carried out via two approaches: subcostal approach with the transducer pointing postero-cephalad and angled slightly to the right and right intercostal approach with transducer pointing medially and all Doppler measurements were performed

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Section: 3: Impact Of Age Group On Hepaticsupporting

confidence: 93%

Section: Caucasians Of Romanian Origin With Valuescontrasting

confidence: 70%

Baseline Nomogram of Hepatic Doppler Parameters and Their Relationship With Visceral Adiposity in Abuja, Nigerian

2019

IJBPAS

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“…Another report found that the grading of esophageal varices correlate positively with portal vein diameter and HA RI; while correlate negatively with portal vein velocity. 16 In conclusion, non-invasive portal hemodynamic parameters are good indicators of the existence and severity of esophageal varices. Subjects with esophageal varices exhibited larger portal vein caliber, splenic size, and HA RI than patients without varices; these parameters exhibited clinically meaningful sensitivity and specificity for the prediction of esophageal varices presence and severity.…”

Section: Discussionmentioning

confidence: 91%

“…15 It was found that portal vein hemodynamics link considerably with the grading of esophageal varices and can potentially discriminate different grades of varices. 16 Nevertheless, there is a rarity in the current data that assessed the predictive role of portal vein hemodynamics in the prediction of the severity of esophageal varices. Thus, we performed the current prospective research to evaluate the diagnostic ability of portal vein hemodynamics for the existence and severity of esophageal varices and to put a cut-off level for different grades of esophageal varices.…”

Section: Introductionmentioning

confidence: 99%

Portal venous hemodynamics as predictors for the development and grades of esophageal varices in Post‐HCV cirrhotic patients: An Egyptian center study

Salman

Saadawy

et al. 2020

Adv in Digestive Medicine

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There is no consensus regarding the precise predictive role of portal vein hemodynamics for the prediction of esophageal varices. We performed the current prospective work to assess the diagnostic ability of portal vein hemodynamics for the prediction and grading of esophageal varices. The present work is a prospective one performed in the period from April 2014 till September 2017. Two hundred patients with HCV-related cirrhosis with esophageal varices were enrolled in the present work as case group (group I). In addition, 100 cirrhotic cases, with no esophageal varices, were included in the work as control arm (group II). Doppler ultrasound (US) and upper endoscopy were performed to all patients. Case group were further subdivided according grades of esophageal varices into four grades. These grades were correlated to splenic size, portal vein velocity, portal vein caliber, and hepatic artery resistivity index. Cases in group I had significantly larger spleen & portal vein diameter and higher hepatic artery resistivity index than cases in group II (P < .001). The portal vein caliber had the highest diagnostic performance for the detection of esophageal varices with cut-off values of ≥12.5 mm (sensitivity = 99% and specificity = 94%). Patients with grade IV varices had significantly elevated values of splenic diameter, portal vein caliber, and hepatic artery resistivity index; and lower portal vein velocity than other patients with lower grades (P < .001). The same findings were observed with other esophageal varices grades. In conclusion, non-invasive portal hemodynamic parameters are good indicators for the prediction and severity of esophageal varices.

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“…Portal hypertension is the leading pathophysiological mechanism for many cirrhotic-related complications with increased mortality and morbidity. The previous reports showed that the elevation in PVP could significantly predict the development and severity of esophageal varices [13], post-operative liver function before liver surgery [14], and survival [15]. More recently, PVP exhibited high sensitivity and specificity in anticipating death in cases with end-stage liver disease, who underwent emergency surgery [16].…”

Section: Introductionmentioning

confidence: 99%

Portal Venous Pressure as a Predictor of Mortality in Child’s A Cirrhotic Patients Undergoing Elective Surgery: A Prospective Study

El‐ghobary¹,

Salman²,

Shaaban³

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Recently, portal venous pressure (PVP) exhibited high sensitivity and specificity in anticipating death in cirrhotic cases submitted to emergency operations. AIM: The current prospective work aimed to evaluate the utility of PVP in predicting 1st month post-operative death in Child’s A cirrhotic cases who underwent elective operations. METHODS: One-hundred and twenty cirrhotic cases that were planned to undergo elective surgery were enrolled in the current prospective work. The intraoperative (I.O) PVP and central venous pressure (CVP) were measured. The statistical analysis was performed using the SPSS version 22.0. The receiver operative curve was plotted to measure the predictive value of PVP. Multivariate analysis was done using logistic regression method for the significant variables impacting mortality on univariate analysis. RESULTS: Twenty-nine patients died in the current work. Patients who survived had statistically considerably lower PVP than patients who died (8.2 ± 1.5 vs. 12.5 ± 1.6 mmHg, respectively, p < 0.001). Similarly, patients who died had significantly higher I.O CVP (p < 0.001), body mass index (p < 0.001), and were more likely to have model for end-stage liver disease score between 9 and 16 (p = 0.003). At a cutoff value ≥10.5 mmHg, the PVP had a sensitivity of 82.8% and specificity of 93.4% for the prediction of mortality. The logistic regression analysis showed that only PVP (odds ratio [OR] =3.1, 95% confidence interval [CI] 1.25–7.5) and CVP (OR = 2.8, 95% CI 1.2–6.5) were the only independent predictors of mortality. CONCLUSION: PVP is a significant predictor of death in Child’s A cirrhotic cases submitted to elective operations.

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Hemodynamic analysis of portal hypertension in patients with liver cirrhosis

Cited by 6 publications

References 0 publications

Baseline Nomogram of Hepatic Doppler Parameters and Their Relationship With Visceral Adiposity in Abuja, Nigerian

Baseline Nomogram of Hepatic Doppler Parameters and Their Relationship With Visceral Adiposity in Abuja, Nigerian

Portal venous hemodynamics as predictors for the development and grades of esophageal varices in Post‐HCV cirrhotic patients: An Egyptian center study

Portal Venous Pressure as a Predictor of Mortality in Child’s A Cirrhotic Patients Undergoing Elective Surgery: A Prospective Study

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