Title: Changes of Portal Flow in Patients with an Acute Exacerbation of Heart Failure and Liver Congestion
Authors:Hassan Zaghla, Maha El Sabawy, Manal Gomma, Sherif Abbass, Eman Abdel Sameea
DOI: http://dx.doi.org/10.18535/jmscr/v3i12.19
Abstract
Background: Acute heart failure may be either new heart failure or worsening of pre-existing chronic heart failure. Liver congestion causes transmission of flow waveforms portal vein.
Aim: to describe changes of portal vein flow in patients with an acute exacerbation of heart failure.
Patients and methods: Thirty patients with exacerbation of chronic heart failure presenting at Heart failure unit, National Heart Institute. Doppler ultrasound and measurement of portal vein pulsatile index (PI) were done for all patients.
Results: Based on PI, the following 4groups were defined: Group 1 (PI < 0.5): 4 patients (13.3%), Group 2 (PI 0.5 – 0.99): 11 patients (36.7%), Group 3 (PI =1): 9 patients (30%) andGroup 4 (PI >1): 6 patients (20%). Mean total serum bilirubin was 1.2 ± 0.4 in group 1, 1.7 ± 0.6 in group 2, 2.1 ± 0.3 in group 3, and 2.8 ± 1 in group 4. This represents a statistically significant linear correlation between PI and total serum bilirubin (p value= 0.01). The mean right atrial pressure (RAP) was 8.5 ± 4 mmHg in group 1, 13.5 ± 5 mmHg in group 2, 20 ± 3.5 mmHg in group 3, and 22 ± 4 mmHg in group 4. This represents a statistically significant linear correlation between PI and RAP (p value= 0.01).
In conclusion: portal vein flow has significant changes in patients with acute exacerbation of heart failure which are proportional to serum level of total bilirubin, RAP, severity of tricuspid regurge and severity of heart failure
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