AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. ...AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP＜10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6±7.3mmHg), PAP (25.0±8.2 mmHg), RAP (4.7±2.4 mmHg), and RVEDP (6.4±2.7 mmHg). Patients in Group 2 had increased PWP (29.9±9.3 mmHg), PAP (46.3±13.2 mmHg), RAP (17.5±5.7 mmHg), and RVEDP (18.3±5.6 mmHg) (P＜0.001).Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area)and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-topeak pulsatility (PP) 27.0±8.9 % (range: 17-40 %). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6±45.6 (range: 43-194 %). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P＜0.001) but not with AOP, LVEDP, PWP, PAP,RAP, and RVEDP.PP showed a good correlation (P＜0.001)with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All the patients with PP ＞40 % had a right-sided heart failure with a RAP=10 mmHg.CONCLUSION: The measurement of PP change is a simple and non-invasive way to identify patients with right heart failure.展开更多
文摘AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP＜10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6±7.3mmHg), PAP (25.0±8.2 mmHg), RAP (4.7±2.4 mmHg), and RVEDP (6.4±2.7 mmHg). Patients in Group 2 had increased PWP (29.9±9.3 mmHg), PAP (46.3±13.2 mmHg), RAP (17.5±5.7 mmHg), and RVEDP (18.3±5.6 mmHg) (P＜0.001).Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area)and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-topeak pulsatility (PP) 27.0±8.9 % (range: 17-40 %). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6±45.6 (range: 43-194 %). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P＜0.001) but not with AOP, LVEDP, PWP, PAP,RAP, and RVEDP.PP showed a good correlation (P＜0.001)with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All the patients with PP ＞40 % had a right-sided heart failure with a RAP=10 mmHg.CONCLUSION: The measurement of PP change is a simple and non-invasive way to identify patients with right heart failure.
