Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

Hu, Jianhe; Yang, Sien–Sing; Lai, Yun-Chih; Shih, Cheng-Yen; Chang, Cheng-Wen

doi:10.3748/wjg.v9.i8.1828

Cited by 23 publications

(16 citation statements)

References 26 publications

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“…Decrease in portal flow is to some extent compensated by an increase in hepatic artery flow – termed the hepatic artery buffer response . Conditions such as right heart failure, caval stenosis, or veno‐occlusive disease, which increase resistance to hepatic outflow, can sig‐nificantly decrease or reverse the portal flow .…”

Section: Portal Hemodynamics and Liver Regenerationmentioning

confidence: 99%

Portal flow modulation in auxiliary partial orthotopic liver transplantation

Rela

Bharathan

Kumar

et al. 2015

Pediatric Transplantation

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APOLT is a suitable technique of liver transplantation in patients with ALF and some types of MLD. Portal venous steal is a problem with this procedure that leads to graft dysfunction and failure. Modulation of the portal flow to the graft and native liver can help in preventing this problem. We discuss the pathophysiology of this complication, review available literature regarding its management, and describe our results using the technique of graded hemiportal banding to achieve adequate perfusion for the graft and native liver.

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Section: Portal Hemodynamics and Liver Regenerationmentioning

confidence: 99%

Portal flow modulation in auxiliary partial orthotopic liver transplantation

Rela

Bharathan

Kumar

et al. 2015

Pediatric Transplantation

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“… 14 , 15 A pulsatile pattern of portal venous flow is interpreted as the transmission of changes in right atrial pressure across the hepatic veins and the sinusoids to the portal vein. 16 , 17 Abnormal portal vein pulsatility (PVP) has been demonstrated to correlate with elevated right atrial pressures 18 and bowel edema in patients with HF, 19 suggesting the potential use of this metric as a noninvasive tool for the assessment of splanchnic compartment. Notably, increased venous congestion along with severe tricuspid regurgitation (TR) related to right heart dysfunction, and altered compliance of the hepatic vascular bed are mechanisms suggested to result in portal hypertension and therefore lead to a markedly pulsatile portal flow.…”

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confidence: 99%

Assessing Splanchnic Compartment Using Portal Venous Doppler and Impact of Adding It to the EVEREST Score for Risk Assessment in Heart Failure

et al. 2020

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Background The Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan (EVEREST) score has proven useful for risk prediction in acute decompensated heart failure (ADHF). However, this score does not include the characterization of the splanchnic compartment, which has been involved in worsening heart failure. Refining this score by integrating an assessment of the splanchnic compartment would allow for a better risk assessment. Therefore, we aimed to characterize the patterns of portal vein pulsatility (PVP), an ultrasound metric used for the assessment of splanchnic compartment and their determinants in patients with ADHF, to explore the relationships between abnormal patterns of PVP and outcomes, and to evaluate the added value of PVP to the EVEREST score for risk assessment in ADHF. Methods Portal vein flow was assessed prospectively on admission and at discharge in 95 patients with ADHF using pulsed-wave Doppler. Abnormal PVP was defined for values ≥ 50%. Cox proportional hazards models were used for the assessment of the relationship between PVP and outcomes. Results Overall, 64% of patients on admission and 24% at discharge had abnormal PVP. PVP on admission was inversely correlated with right ventricular function (tricuspid annular plane systolic excursion, ρ = −0.434) and pulmonary pressure (ρ = 0.346), P < 0.05. Although PVP was associated with all-cause mortality (hazard ratio, 1.028, P < 0.001), the addition of this metric to the EVEREST score had little effect on its C-index (0.813 vs 0.818) for risk assessment. Conclusions Abnormal PVP is frequent and associated with right ventricular dysfunction in ADHF. Although abnormal PVP identifies higher-risk patients, this metric does not improve the performance of the EVEREST score for risk assessment.

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“…Also, Jui-Ting Hu, et al 2003 who studied the peak-to-peak PI of portal blood flow in order to predict the right-sided congestion in CHF patients. They concluded that the measurement of Portal vein flow changes identify patients with CHF (7) . This finding adds more evidence to our result.…”

Section: Discussionmentioning

confidence: 99%

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

Zaghla¹,

Sabawy²,

Gomma³

et al. 2015

JMSCR

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Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

Abstract: The measurement of PP change is a simple and non-invasive way to identify patients with right heart failure.

Cited by 23 publications

References 26 publications

Portal flow modulation in auxiliary partial orthotopic liver transplantation

Portal flow modulation in auxiliary partial orthotopic liver transplantation

Assessing Splanchnic Compartment Using Portal Venous Doppler and Impact of Adding It to the EVEREST Score for Risk Assessment in Heart Failure

Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion

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