Changes features of middle hepatic vein flow velocity waveform in patients with pulmonary hypertension caused by congenital heart disease

Abstract

Objective To analyze the Doppler flow spectra of middle hepatic vein (MHV) in patients with pulmonary hypertension (PH) caused by congenital heart disease (CHD), and to explore a new non-invasive method for evaluating PH by echocardiography. Methods Atrial septal defect, ventricular septal defect, patent patent ductus arteriosus and other 80 patients with congenital heart disease were collected from Fourth Military Medical University, Tangdu Hospital and General Hospital of Shenyang Military Area Command between January 2012 and June 2013. The pulmonary artery pressure was measured by right heart catheterization. The patients were divided into healthy control group, mild PH group, moderate PH group and severe PH group according to different pulmonary artery pressure. The peak velocities and velocity time integral (VTI) of the atrial reversal wave (AR), ventricular systolic wave (S), ventriclar diastolic wave (D) were measured at the end of inspiratory. Results The differences of following parameters were statistically significant between the healthy control group, mild PH group, moderate PH group and severe PH group: velocity time integral of ventricular systolic wave (SVTI), velocity time integral of ventricular diastolic wave (DVTI), AR, AR/S, ARVTI/SVTI, AR/(S+ D), ARVTI/(SVTI+ DVTI, F=2.940, 2.838, 3.373, 7.681, 3.478, 12.052, 4.806; P<0.05, <0.05, <0.05, <0.01, <0.05, <0.01, <0.01). Correlation analysis showed that ratio of AR/(S+ D) was positively correlated with pulmonary artery mean pressure (r = 0.575, P<0.01). Conclusions The ratio of AR/(S+ D) of MHV Doppler flow spectra was correlated with pulmonary artery mean pressure. The ratio increased along with the increasing of pulmonary pressure in CHD patient. The Doppler echocardiographic detection of MHV flow had a certain reference value for the diagnosis of PH. The ratio of AR/(S+ D) could be a new non-invasive parameter for evaluating PH. Key words: Ultrasonography; Pulmonary hypertension; Middle hepatic vein; Right heart catheterization