title: Hemodynamic changes of the middle hepatic vein in patients with pulmonary hypertension using echocardiography.
abstract: The aim of this study was to analyze the changes of the middle hepatic vein (MHV) spectra in patients with pulmonary hypertension (PH) caused by congenital heart disease (CHD) and determine the proper parameters of MHV to predict PH. Eighty patients with CHD were included, whose pulmonary artery pressure was measured via right heart catheterization, and the MHV spectra were detected via echocardiography. The peak value of velocity (V) and velocity time integral (VTI) of the waves, including S wave, D wave and A wave, were measured at the end of inspiration. The values of the MHV parameters that were predictive of PH were evaluated and their cut-off points were determined. Compared with the control group, V of S wave (S), VTI of S wave (SVTI), V of D wave (D), VTI of D wave (DVTI) decreased and V of A wave (A), VTI of A wave (AVTI), A/S, AVTI/SVTI, A/(S+D), AVTI/ (SVTI+DVTI) increased in the PH group. These differences were statistically significant (P<0.05). A correlation analysis determined that the ratios of A/S, A/(S+D), AVTI/(SVTI+DVTI) were positively correlated with pulmonary artery mean pressure (r=0.529,0.575,0.438,P<0.001). An ROC curve analysis determined that the diagnostic effect of A/(S+D) was superior to the other two parameters. On the ROC curve, when the ratio of A/(S+D) was 0.30, the sensitivity was 85.37% and specificity was 75.00% for predicting PH. The spectral parameters of MHV, including the ratios of A/S, A/(S+D) and AVTI/(SVTI+DVTI), increased with increasing pulmonary pressure in CHD patients. When the ratio of A/(S+D) was 0.30 in MHV spectra, it had sufficient sensitivity and specificity for diagnosing PH, and this method could be used as a new non-invasive complementary echocardiographic parameter for predicting PH.
authors.affiliation: Department of Stomatology and Medical Imaging, Jilin Medical College, Jilin, Jilin Province, China; Department of Ultrasound Diagnosis, Tangdu Hospital of the Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Dan Dan
authors.initials: DD
authors.lastname: Sun
authors.affiliation: Department of Congenital Heart Disease Internal, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning Province, China.
authors.forename: Chuan Ju
authors.initials: CJ
authors.lastname: Hou
authors.affiliation: Department of Ultrasound Diagnosis, Tangdu Hospital of the Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Li Jun
authors.initials: LJ
authors.lastname: Yuan
authors.affiliation: Department of Ultrasound Diagnosis, Tangdu Hospital of the Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Yun You
authors.initials: YY
authors.lastname: Duan
authors.affiliation: Department of Ultrasound Diagnosis, Tangdu Hospital of the Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Ultrasound Diagnosis, Affiliated Hospital of Jilin Medical College, Jilin, Jilin Province, China.
authors.forename: Fang Ping
authors.initials: FP
authors.lastname: Zhou
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006439:Hemodynamics / Q000502:physiology*; D006503:Hepatic Veins / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology*; D001239:Inhalation / Q000502:physiology; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology; D012680:Sensitivity and Specificity; D014655:Vascular Resistance / Q000502:physiology
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