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首页> 美国卫生研究院文献>World Journal of Gastroenterology >Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure
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Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

机译：门脉血流峰峰值的百分比可预测右侧充血性心力衰竭

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AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP < 10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12 h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6 ± 7.3 mmHg), PAP (25.0 ± 8.2 mmHg), RAP (4.7 ± 2.4 mmHg), and RVEDP (6.4 ± 2.7 mmHg). Patients in Group 2 had increased PWP (29.9 ± 9.3 mmHg), PAP (46.3 ± 13.2 mmHg), RAP (17.5 ± 5.7 mmHg), and RVEDP (18.3 ± 5.6 mmHg) (P < 0.001). Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area) and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-to-peak pulsatility (PP) 27.0% ± 8.9% (range: 17% - 40%). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6 ± 45.6 (range: 43%-194%). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P < 0.001) but not with AOP, LVEDP, PWP, PAP, RAP, and RVEDP. PP showed a good correlation (P < 0.001) with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All the patients with PP > 40% had a right-sided heart failure with a RAP = 10 mmHg.CONCLUSION: The measurement of PP change is a simple and non-invasive way to identify patients with right heart failure.
机译：目的：通过非侵入性方法研究门脉血流量的变化，以预测右侧心力衰竭的状况。方法：我们研究了20例风湿性和动脉粥样硬化性心脏病患者。所有患者在研究前1周均具有恒定的全身血压和体重。心脏指数（CI），左心室舒张末期压力（LVEDP），平均主动脉压（AOP），肺楔压（PWP），平均肺动脉压（PAP），平均右心房压力（RAP），右心室末端在心脏导管插入过程中记录舒张压（RVEDP）。将10例RAP <10 mmHg的患者归为第1组。其余10例RAP≥10 mmHg的患者归为第2组。在心脏导管插入术后12 h内，使用超声多普勒研究门静脉血流图。结果：CI，AOP ，而LVEDP在两组之间没有差异。第1组患者的PWP（14.6±7.3 mmHg），PAP（25.0±8.2 mmHg），RAP（4.7±2.4 mmHg）和RVEDP（6.4±2.7 mmHg）正常。第2组患者的PWP（29.9±9.3 mmHg），PAP（46.3±13.2 mmHg），RAP（17.5±5.7 mmHg）和RVEDP（18.3±5.6 mmHg）增加（P <0.001）。两组的最大门脉血流速度（Vmax），平均门脉血流速度（Vmean），横截面积（Area）和门脉血流量（PBF）的平均值无差异。第一组的所有患者均具有连续的顺行门脉血流，平均峰峰脉动率（PP）为27.0％±8.9％（范围：17％-40％）。第2组的所有患者均具有脉搏门脉血流，平均PP 86.6±45.6（范围：43％-194％）。一名患者暂时停滞，三名患者发生短暂的肝门静脉血流，主要发生在心室收缩期。 Vmax，Vmean和PBF与CO呈正相关（P <0.001），但与AOP，LVEDP，PWP，PAP，RAP和RVEDP无正相关。 PP与PWP，PAP，RAP和RVEDP表现出良好的相关性（P <0.001），而与CI，AOP和LVEDP则没有相关性。所有PP> 40％的患者均发生右侧心力衰竭，RAP = 10 mmHg。结论：PP变化的测量是一种简单且无创的方法，可识别右心力衰竭患者。

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