Assessment of tricuspid regurgitation by pulsed doppler ultrasonography of the hepatic veins

Pennestrì, Faustino; Loperfido, Francesco; Salvatori, Mauro Pellegrino; Mongiardo, Rocco; Ferrazza, Angelo; Guccione, Paolo; Manzoli, U

doi:10.1016/0002-9149(84)90198-x

Cited by 82 publications

(45 citation statements)

References 19 publications

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“…TR is known to affect tricuspid inflow and hepatic vein Doppler parameters [2, 7, 8]. The typical Doppler pattern with TR is blunting of the hepatic vein S wave and elevation of the tricuspid inflow E wave due to the regurgitant volume.…”

Section: Discussionmentioning

confidence: 99%

Effect of Age, Heart Rate and Tricuspid Regurgitation on the Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function

Spencer¹,

Weinert²,

Lang³

1999

Cardiology

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Pulsed-wave Doppler analysis of tricuspid inflow and hepatic venous flow allows the determination of multiple parameters of right-ventricular (RV) diastolic function. This study sought to evaluate the influence of heart rate, age and tricuspid regurgitation on Doppler parameters of RV diastolic performance. We studied 80 subjects (20 normal and 60 with RV pathology) with Doppler recordings of the tricuspid inflow and hepatic vein. All tricuspid Doppler parameters were dependent on heart rate, age or regurgitation severity as were the hepatic vein S wave, S/D ratio and systolic filling fraction. The atrial reversal velocity in the hepatic vein Doppler tracing was not affected by age, heart rate or regurgitation. In addition, the inspiratory increase in this parameter was significantly elevated in RV pathologic states. This study demonstrates that most Doppler echocardiographic parameters of RV diastolic performance are dependent on age, tricuspid regurgitation or heart rate.

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Section: Discussionmentioning

confidence: 99%

Effect of Age, Heart Rate and Tricuspid Regurgitation on the Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function

Spencer¹,

Weinert²,

Lang³

1999

Cardiology

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“…More detailed observation shows that it consists of large antegrade systolic and diastolic waves, and small retrograde v, a, and rarely c waves [6]. The waveform is modified in patients with tricuspid regurgitation [6,7], hepatic congestion secondary to right heart failure [8] Budd-Chiari syndrome [9][10][11] and chronic parenchymal liver diseases [8,9,12,13]. It is widely regarded that the waveform becomes flat when hepatocellular function is impaired.…”

Section: Discussionmentioning

confidence: 99%

Hepatic vein waveforms in liver cirrhosis re-evaluated

2010

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Objective There are many studies on changes in Doppler waveforms of hepatic veins in cirrhotic liver. It is postulated that dampening of phasic oscillations appears with worsening of liver function. Our aim was to reevaluate the significance of Doppler waveforms of hepatic vein in cirrhotic patients and to correlate with hepatic blood flow. Patients and method One hundred and thirty-five consecutive patients of liver cirrhosis and 60 age and sex matched non-cirrhotic controls were enrolled in this study. Doppler waveforms were obtained from right hepatic vein during normal respiration. Other parameters measured were flow volume of portal trunk, right portal vein and proper hepatic artery. Result Waveforms of the hepatic vein were classified into triphasic, biphasic and flat patterns. Flat waveform was rare and appeared in only 3% cases. There was no correlation between liver dysfunction and patterns of waveforms. Inflow, particularly to the right lobe, was significantly elevated in cases associated with the non-triphasic waveforms. Conclusion This study shows that the flat waveforms have no diagnostic value. Role of hepatic blood flow seems to be important suggesting hemodynamic changes rather than liver dysfunction as a plausible cause of change in waveforms.

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“…This retrograde nature of pulsatile flow has been described in different studies on hepatic Doppler ultrasonography at the level of the middle suprahepatic vein, where it has been correlated with the presence of tricuspid regurgitation. 3,7 It has also been described in the portal vein, where some authorities consider it a sign of tricuspid regurgitation, 3 whereas others relate it to congestive cardiac failure. 3,[16][17][18] Nonetheless, hardly any publications in the medical literature correlate the rise in right atrial pressure with the pulsatile wave spectrum in Doppler studies in the lower limbs.…”

Section: Discussionmentioning

confidence: 99%

“…We based our study on pulsed Doppler sonographic work on the liver that links portal vein pulsatility to congestive failure 6 and other studies that consider the suprahepatic vein pulsatility as a sign of tricuspid regurgitation. 3,7 We also analyzed if it was possible to predict right cardiac failure in patients with pulsatile flow.…”

mentioning

confidence: 99%

Correlation of central venous pressure with Doppler waveform of the common femoral veins.

Cozcolluela

Sarría

Sanz

et al. 2000

Journal of Ultrasound in Medicine

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The objects of this prospective study were to determine the nature of the flow in the right femoral vein and to correlate the flow velocity with the venous pressure measured in the right atrium. We performed 236 pulsed Doppler ultrasonographic examinations in 1 year on patients with a venous catheter with the distal tip in the right atrium. In the Doppler wave readouts we analyzed wave frequency, velocity components, and relationships among them and the existence of pulsatile flow. These parameters were then compared to the right atrium pressure. We investigated the correlation between the atrium pressure and the flow velocity obtained from the Doppler waveforms of the common femoral veins, obtaining a significant correlation (P<0.0001) with the following: the atrium systolic wave a, the atrium diastolic wave v, the pulsatility ratio (PR = Vmin/Vmax) and the pulsatility index (PI = [Vmax ‐ Vmin] /Vavg). The receiver operating characteristic showed that the pulsed Doppler ultrasonography is not a sensitive technique in diagnosis high atrium pressures. In addition, both cardiac and respiratory phasicity of the venous wave was observed. A significant inverse relation was found between the pulsatile flow and high atrium pressure. Nonetheless, the low sensitivity of this technique does not allow the use of pulsatile Doppler ultrasonography in the common femoral vein for diagnosing increases of the atrium pressure.

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Assessment of tricuspid regurgitation by pulsed doppler ultrasonography of the hepatic veins

Cited by 82 publications

References 19 publications

Effect of Age, Heart Rate and Tricuspid Regurgitation on the Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function

Effect of Age, Heart Rate and Tricuspid Regurgitation on the Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function

Hepatic vein waveforms in liver cirrhosis re-evaluated

Correlation of central venous pressure with Doppler waveform of the common femoral veins.

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