Document Detail


Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis: a prospective nonrandomized study.
MedLine Citation:
PMID:  17845539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Alterations in the Doppler hepatic vein (HV) waveform are associated with cirrhosis and portal hypertension. We prospectively evaluated the correlation between the extent of abnormal Doppler HV waveforms expressed as damping index (DI) and the hepatic venous pressure gradient (HVPG) and response to propranolol in patients with cirrhosis. MATERIAL AND METHODS: In 76 patients with cirrhosis (69 men and seven women), both DI of Doppler HV waveform and HVPG were measured, and the relationship between them was analysed. DI was calculated by the minimum velocity/maximum velocity of the HV waveform. An HVPG>12 mmHg was defined as severe portal hypertension. In a subgroup of 19 patients receiving propranolol, changes in both DI and HVPG were evaluated after propranolol administration for 3 months. One author (S. K. B.) performed all DI of Doppler HV waveform studies. RESULTS: Abnormal HV waveforms were seen in 66 of 76 patients (86.8%). DI significantly correlated with the grade of HVPG, i.e. with higher HVPG increased DI was observed (P<0.01). By logistic regression analysis, DI>0.6 was significantly more likely to be severe portal hypertension (odds ratio: 14.19, 95% confidence interval: 4.07-49.55). Receiver-operating characteristic curve according to the value of 0.6 of DI showed a sensitivity of 75.9% and a specificity of 81.8% for the presence of severe portal hypertension. In 19 patients of the propranolol subgroup, change of DI following propranolol treatment also significantly correlated with that of HVPG (P<0.01). CONCLUSIONS: Damping index of the HV waveform by Doppler ultrasonography might be a non-invasive supplementary tool in evaluating the severity of portal hypertension and in responding to propranolol in patients with liver cirrhosis.
Authors:
Moon Young Kim; Soon Koo Baik; Dong Hun Park; Dae Wook Lim; Jae Woo Kim; Hyun Soo Kim; Sang Ok Kwon; Young Ju Kim; Sei Jin Chang; Samuel S Lee
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  27     ISSN:  1478-3223     ISO Abbreviation:  Liver Int.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-11     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1103-10     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / pharmacology,  therapeutic use*
Female
Hepatic Veins / drug effects,  physiopathology,  ultrasonography*
Humans
Hypertension, Portal / drug therapy*,  etiology,  physiopathology,  ultrasonography*
Linear Models
Liver Cirrhosis / complications*,  drug therapy,  physiopathology,  ultrasonography
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Propranolol / pharmacology,  therapeutic use*
Prospective Studies
ROC Curve
Reproducibility of Results
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Treatment Outcome
Ultrasonography, Doppler, Duplex*
Venous Pressure / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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