Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension

Fadel, Bahaa M.; Husain, Aysha; Alassoussi, Nader; Dahdouh, Ziad; Mohty, Dania

doi:10.1111/echo.12710

Cited by 21 publications

(88 citation statements)

References 15 publications

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“…Blood flow in the hepatic veins (HVs) is tightly tied to the cardiac cycle and right heart hemodynamics . Additionally the respiratory cycle exerts some influence on HV flow pattern .…”

mentioning

confidence: 99%

“…Most disease states that involve the right heart affect the HV Doppler in a manner independent of the respiratory cycle . Therefore, neither inspiration nor expiration alters the HV flow in a cycle‐specific manner.…”

mentioning

confidence: 99%

“…Therefore, neither inspiration nor expiration alters the HV flow in a cycle‐specific manner. Some diseases, however, lead to alterations in the HV profile in a manner that is dependent on the respiratory cycle . Under such circumstances inspiration or expiration confers a phasic alteration on the HV flow that reflects the nature of the underlying disease process.…”

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confidence: 99%

“…Recognition of the respiratory dependent changes in the HV Doppler carries important diagnostic as well as prognostic implications. Thus, analysis of the HV Doppler should include an assessment of the respiration‐dependent filling pattern of the right heart …”

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confidence: 99%

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Respiratory Hemodynamics in the Hepatic Veins—Abnormal Patterns

et al. 2014

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The flow pattern in the hepatic veins (HVs) is dependent on the cardiac cycle and right heart hemodynamics and influenced by the respiratory cycle and the liver parenchyma. Most disease states that affect the right heart alter the HV Doppler in a manner independent of the respiratory cycle. Some diseases that typically involve the pericardium, right ventricular myocardium, or respiratory system confer characteristic changes to the HV flow in a manner dependent on the respiratory cycle. Analysis of the HV Doppler with assessment of the respiratory changes in flow and their timing helps to distinguish among the various disease states. In this manuscript, we discuss the effect of respiration on HV flow in patients with abnormal right heart function and illustrate the use of the respiratory changes in the HV Doppler as a tool for diagnosis.

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“…Blood flow in the hepatic veins (HVs) is tightly tied to the cardiac cycle and right heart hemodynamics . Additionally the respiratory cycle exerts some influence on HV flow pattern .…”

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Respiratory Hemodynamics in the Hepatic Veins—Abnormal Patterns

et al. 2014

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“…8,9 However, this pattern is encountered in a minority of obese individuals. [4][5][6] Inspiration is associated with a decrease in intrathoracic pressure and thus results in a physiological increase in the forward flow velocities (S and D). 4).…”

Section: Discussion: Liver Diseasementioning

confidence: 99%

Spectral Doppler of the Hepatic Veins in Noncardiac Diseases: What the Echocardiographer Should Know

et al. 2015

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In most instances, the flow profile in the hepatic veins (HVs) reflects the fluctuation of pressure within the right atrium. Thus, interrogation of blood flow in the HVs is highly useful for the evaluation of right heart hemodynamics and has become an integral part of any routine echocardiographic examination. However, flow in the HVs is also affected by the state of the liver parenchyma and by the fluctuation of pressure within the thoracic cavity. Therefore, liver and pulmonary pathologies influence the flow pattern in the HVs and may lead to its dissociation from right heart hemodynamics. Echocardiographers should familiarize themselves with the findings on HV Doppler in noncardiac diseases to avoid misinterpretation and incorrect diagnosis.

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Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism

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et al. 2020

J of Clinical Ultrasound

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Purpose: Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status.Methods: We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows.Result: A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD.Conclusion: HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE. K E Y W O R D SDoppler ultrasonography, hepatic veins, pulmonary embolism, right ventricle

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Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension

Cited by 21 publications

References 15 publications

Respiratory Hemodynamics in the Hepatic Veins—Abnormal Patterns

Respiratory Hemodynamics in the Hepatic Veins—Abnormal Patterns

Spectral Doppler of the Hepatic Veins in Noncardiac Diseases: What the Echocardiographer Should Know

Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism

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