Portal vein pulsatility index is a more important indicator than congestion index in the clinical evaluation of right heart function.
OBJECTIVE
To study the changes of portal blood flow in congestive heart failure.


METHODS
We studied the congestion index (CI) and portal vein pulsatility index (PI) in patients with varied degrees of congestive heart failure using ultrasonic Doppler. Ten patients with (mean) right atrial pressure (RA) < 10 mmHg were classified as group 1 and the remaining 10 patients with RA > or = 10 mmHg as group 2.


RESULTS
There were no difference on cardiac index (HI, P=0.28), aortic pressure (AO, P=0.78), left ventricular end-diastolic pressure (LVED, P=0.06), (max)imum portal blood velocity (Vmax, P=0.17), (mean) portal blood velocity (Vmean, P=0.15) and portal blood flow volume (PBF, P=0.95) between the two groups. Group 2 patients had higher pulmonary wedge pressure (PW, 29.9+/-9.3 mmHg vs 14.6+/-7.3 mmHg, P=0.002), pulmonary arterial pressure (PA, 46.3+/-13.2 mmHg vs 25.0+/-8.2 mmHg, P=0.004), RA (17.5+/-5.7 mmHg vs 4.7+/-2.4 mmHg, P<0.001), right ventricular end-diastolic pressure (RVED, 18.3+/-5.6 mmHg vs 6.4+/-2.7 mmHg, P<0.001), CI (8.7+/-2.4 vs 5.8+/-1.2, P=0.03), and PI (87.8+/-32.3% vs 27.0+/-7.4%, P<0.001) than Group 1. CI was correlated with PI (P<0.001), PW (P<0.001), PA (P<0.001), RA (P=0.043), RVED (P=0.005), HI (P<0.001), AO (P<0.001), CO (P<0.001), LVED (P<0.001), Vmax (P<0.001), Vmean (P<0.001), cross-sectional area of the main portal vein (P<0.001) and PBF (P<0.001). CI could be as high as 8.3 in patients with RA < 10 mmHg and as low as 5.9 in those with RA > or = 10 mmHg.


CONCLUSIONS
Our data show that RI is a more significant indicator than CI in the clinical evaluation of high RA > or = 10 mmHg, whereas CI is better than PI in the assessment of left heart function.
Shih
Cheng-Yen
CY
Liver Unit, Cathay General Hospital, Taipei 106, Taiwan, China.
Yang
Sien-Sing
SS
Hu
Jui-Ting
JT
Lin
Chin-Lin
CL
Lai
Yung-Chih
YC
Chang
Cheng-Wen
CW
D000328:Adult; D000368:Aged; D016280:Atrial Function, Right; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006334:Heart Function Tests / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D011673:Pulsatile Flow