Document Detail


Doppler ultrasound of hepatic and system hemodynamics in patients with alcoholic liver cirrhosis.
MedLine Citation:
PMID:  19277866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. PATIENTS AND 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:
Drazen Zekanovic; Zekanovic Drazen; Neven Ljubicic; Ljubicic Neven; Marko Boban; Boban Marko; Marko Nikolic; Nikolic Marko; Diana Delic-Brkljacic; Delic-Brkljacic Diana; Petar Gacina; Gacina Petar; Ivo Klarin; Klarin Ivo; Jadranko Turcinov; Turcinov Jadranko
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-03-10
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  55     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-12     Completed Date:  2010-02-18     Revised Date:  2010-03-01    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  458-66     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, County Hospital Zadar, Zadar, Croatia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Flow Velocity / physiology
Blood Pressure / physiology*
Female
Follow-Up Studies
Hepatic Artery / physiopathology*,  ultrasonography
Humans
Liver Circulation / physiology*
Liver Cirrhosis, Alcoholic / physiopathology*,  ultrasonography
Male
Middle Aged
Portal Vein / physiopathology*,  ultrasonography
Prognosis
Severity of Illness Index
Ultrasonography, Doppler, Color / methods*
Vascular Resistance / physiology*
Comments/Corrections
Erratum In:
Dig Dis Sci. 2009 Jun;54(6):1377
Note: Drazen, Zekanovic [corrected to Zekanovic, Drazen]; Neven, Ljubicic [corrected to Ljubicic, Neven]; Marko, Boban [corrected to Boban, Marko]; Marko, Nikolic [corrected to Nikolic, Marko]; Diana, Delic-Brkljacic [corrected to Delic-Brkljacic, Diana]; Petar, Gacina [corrected to Gacina, Petar]; Ivo, Klarin [corrected to Klarin, Ivo]; Jadranko, Turcinov [corrected to Turcinov, Jadranko]

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