title: Doppler ultrasound of hepatic and system hemodynamics in patients with alcoholic liver cirrhosis.
abstract: OBJECTIVE
  The progression of liver cirrhosis eventually increases cardiac output, while blood pressure and systemic vascular resistance are reduced. A complex behavior of portal hemodynamic to hepatic artery and system circulation has not yet been presented. There is a lack in knowledge about the correlation of local and systemic circulation parameters to the degree of liver failure, with respect to presence of ascites and esophageal varices.
  
  
  METHODS
  The study sample was 76 patients hospitalized for established alcoholic liver cirrhosis. Patients were divided into groups according to Child-Pugh clinical score; grade A (n = 24), B (n = 18) and C (n = 18). Ascites was found in 28 patients and esophageal varices in 46. Portal vein flow velocity (PVFV), hepatic artery resistance index (HARI), heart and great vessels within mediastinal cavity were assessed with ultrasound devices equipped with spectral Doppler.
  
  
  RESULTS
  Significant differences in mean blood pressure, systemic vascular resistance index (SVRI) minute volume, cardiac index and PVFV were found in the group of patients with the most severe stage (C). In regard to presence of ascites statistically significant difference was observed in elevated mean blood pressure and SVRI. Correlation was found between conjugated HARI to blood pressure and to SVRI.
  
  
  CONCLUSIONS
  In patients with liver cirrhosis there is an inversely reciprocal relationship of conjugated HARI with PVFV, correlating to disease grade. PVFV in cirrhosis decreases and HARI values were over 0.7. Study demonstrated that combining echocardiography with abdominal Doppler ultrasound served as valuable non-invasive diagnostic insight in liver and systemic circulation among different grade of cirrhosis.
authors.affiliation: Department of Internal Medicine, County Hospital Zadar, Zadar, Croatia.
authors.forename: Drazen
authors.initials: D
authors.lastname: Zekanovic
authors.forename: Zekanovic
authors.initials: Z
authors.lastname: Drazen
authors.forename: Neven
authors.initials: N
authors.lastname: Ljubicic
authors.forename: Ljubicic
authors.initials: L
authors.lastname: Neven
authors.forename: Marko
authors.initials: M
authors.lastname: Boban
authors.forename: Boban
authors.initials: B
authors.lastname: Marko
authors.forename: Marko
authors.initials: M
authors.lastname: Nikolic
authors.forename: Nikolic
authors.initials: N
authors.lastname: Marko
authors.forename: Diana
authors.initials: D
authors.lastname: Delic-Brkljacic
authors.forename: Delic-Brkljacic
authors.initials: DB
authors.lastname: Diana
authors.forename: Petar
authors.initials: P
authors.lastname: Gacina
authors.forename: Gacina
authors.initials: G
authors.lastname: Petar
authors.forename: Ivo
authors.initials: I
authors.lastname: Klarin
authors.forename: Klarin
authors.initials: K
authors.lastname: Ivo
authors.forename: Jadranko
authors.initials: J
authors.lastname: Turcinov
authors.forename: Turcinov
authors.initials: T
authors.lastname: Jadranko
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008102:Liver Circulation / Q000502:physiology*; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology*