The characteristics of hepatic venous flow velocity pattern in patients with pulmonary hypertension by pulsed Doppler echocardiography.

Zhang-An,; Himura, Yoshihiro; Kumada, Toshiaki; Hayashida, Wataru; Ishikawa, N.; Noda, Mika; Kohno, Fujimasa; Kambayashi, Masashi; Kawai, C

doi:10.1253/jcj.56.317

Cited by 23 publications

(5 citation statements)

References 11 publications

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“…For example, severe pulmonary hypertension can manifest as prominent "A" waves and or/ decreased "D" wave amplitude because of increase in RV end-diastolic pressure. 45 Systolic dysfunction of the RV and tricuspid regurgitation (TR) both alter the RA pressure during ventricular systole leading to progressive decrease in the peak velocity of the "S" wave. 46 In addition, severe TR can cause S wave reversal.…”

Section: Hepatic Vein Dopplermentioning

confidence: 99%

“…Understanding the origin of hepatic flow waves aids in understanding common pathologic alterations. For example, severe pulmonary hypertension can manifest as prominent A waves and/or decreased D wave amplitude because of an increase in RV end-diastolic pressure (45). Systolic dysfunction of the RV and tricuspid regurgitation (TR) both alter the RAP during ventricular systole, leading to progressive decrease in the peak velocity of the S wave (46).…”

Section: Hepatic Vein Dopplermentioning

confidence: 99%

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Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography

2021

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The management of complex fluid and electrolyte disorders is central to the practice of nephrologists. The sensitivity of physical examination alone to determine fluid status is limited, precluding accurate clinical decision making. Point-of-Care Ultrasonography (POCUS) is emerging as a valuable non-invasive bedside diagnostic tool for objective evaluation of physiological and hemodynamic parameters related to fluid status, tolerance, and responsiveness. Rapid bedside sonographic evaluation can obtain qualitative data on cardiac function as well as quantitative data on pulmonary congestion. Advanced POCUS, including goal-directed Doppler echocardiography provides additional quantitative information including flow velocities and pressures across the cardiac structures. Recently, abnormal Doppler flow patterns in abdominal organs secondary to increased right atrial pressure have been linked to congestive organ damage adding another component to the hemodynamic assessment. Integrating POCUS findings with clinical and laboratory data can further elucidate a patient's hemodynamic status. This drives decisions regarding crystalloid administration or, conversely, diuresis or ultrafiltration and allows tailored therapy for individual patients. In this article, we provide an overview of the focused assessment of cardiovascular function, pulmonary and venous congestion using POCUS and review relevant literature.

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Section: Hepatic Vein Dopplermentioning

confidence: 99%

Section: Hepatic Vein Dopplermentioning

confidence: 99%

Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography

2021

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“…A/S, A/(S + D), AVTI/(SVTI + DVTI) were positively correlated with mPAP (3). It was previously shown that PHT group had higher A velocity ;VTI A ;VTI A/VTI S + VTI D were higher in PHTN patients compared to healthy controls (14). Inclusion of patients with PHTN with and without signi cant RV dysfunction in this study enabled us to evaluate the effect of RV dysfunction on PHTN.…”

Section: Discussionmentioning

confidence: 87%

“…The normal ow-pattern in the middle HV is phasic, in which the most predominant velocities are antegrade. Pulsed-wave Doppler assessment describes 3-4 distinct waveforms after atrial contraction: (1) large systolic antegrade wave (negative velocity) (S-wave); (2) small retrograde late systolic wave (positive velocity) (V-wave), (3) early to mid-diastolic antegrade wave (D-wave), (4) late diastolic retrograde wave (A-wave) (14).…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of echocardiography of the Hepatic Vein in Pulmonary Hypertension

Ghaderi

Vakilian

Poorzand

et al. 2023

Preprint

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Background Doppler echocardiographic parameters of the middle hepatic vein (MHV)in detecting PHTN. Methods The study comprised 72 patients who were referred for right heart catheterization (RHC) to our department. All patients underwent conventional transthoracic echocardiography (TTE) the day after RHC and Doppler study of the MHV. Based on RHC and TTE results ,Patients were divided in three groups 1: patients with PHTN without significant RV dysfunction (n = 25), 2: patients with PHTN with significant RV dysfunction (n = 22), 3: patients with normal PAP (n = 25). Results The analysis revealed a significant relationship between A velocity and PHTN among patients with significant RV dysfunction (p = 0.033) and PHTN without significant RV dysfunction (p = 0.020). At cut-off value of 39.5 cm/s, A velocity could detect PHTN in patient with significant RV dysfunction with sensitivity and specificity of 77.3% and 56.0%, respectively. At cut-off value of 38.5 cm/s, A velocity could detect PHTN without significant RV dysfunction with sensitivity and specificity of 76.0% and 51.0%, respectively. The ROC curve analysis was performed to assess the sensitivity of the hepatic venous systolic filling fraction in detecting normal SPAP in the study population. The area under curve was 0.718. Considering the cut-off value of 0.535 for the hepatic venous systolic filling fraction, the sensitivity and specificity of S/S + D for detecting normal SPAP were 80% and 64%, respectively . Discussion Doppler echocardiographic parameters of the MHV could be helpful in detecting PHTN. A/S higher than 1 in PHTN was the main finding on HV Doppler assessment in PHT with and without significant RV dysfunction. HV systolic filling fraction more than 0.535 was a sensitive parameter in detecting normal PAP, therefore; HV systolic filling fraction can be used as a screening echocardiographic parameter in ruling out PHTN.

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“…As congestion worsens, the S wave becomes blunted until it is reversed [102]. Despite the fluid status, a systolic flow reversal is often observed in severe tricuspid regurgitation, whereas, in advanced pulmonary hypertension, A waves appear elevated together with decreased D wave amplitudes because of the elevated RV end-diastolic pressure [103].…”

Section: Hepatic Vein Flowmentioning

confidence: 99%

The Incremental Role of Multiorgan Point-of-Care Ultrasounds in the Emergency Setting

D’Andrea

Giudice

Fabiani

et al. 2023

IJERPH

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Point-of-care ultrasonography (POCUS) represents a goal-directed ultrasound examination performed by clinicians directly involved in patient healthcare. POCUS has been widely used in emergency departments, where US exams allow physicians to make quick diagnoses and to recognize early life-threatening conditions which require prompt interventions. Although initially meant for the real-time evaluation of cardiovascular and respiratory pathologies, its use has been extended to a wide range of clinical applications, such as screening for deep-vein thrombosis and trauma, abdominal ultrasonography of the right upper quadrant and appendix, and guidance for invasive procedures. Moreover, recently, bedside ultrasounds have been used to evaluate the fluid balance and to guide decongestive therapy in acutely decompensated heart failure. The aim of the present review was to discuss the most common applications of POCUS in the emergency setting.

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The characteristics of hepatic venous flow velocity pattern in patients with pulmonary hypertension by pulsed Doppler echocardiography.

Cited by 23 publications

References 11 publications

Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography

Comprehensive Assessment of Fluid Status by Point-of-Care Ultrasonography

The Diagnostic Value of echocardiography of the Hepatic Vein in Pulmonary Hypertension

The Incremental Role of Multiorgan Point-of-Care Ultrasounds in the Emergency Setting

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