Vascular reserve in the lower limbs of cirrhotic patients: a duplex Doppler ultrasound study

Abstract

Aim. To evaluate femoral artery impedance at rest and during reactive hyperaemia. Patients. Study population comprised 11 cirrhotic patients without ascites, 10 with ascites and 16 age- and sex-matched healthy subjects. Methods. Echocardiographic assessment of systemic haemodynamics; duplex Doppler ultrasound measurement of femoral artery pulsatility index and vascular reserve (pulsatility index rest/pulsatility index hyperaemia). Results. Cirrhotic patients had elevated cardiac index and low systemic vascular resistance. Pulsatility index (right femoral artery) was not statistically different either at rest or after reactive hyperaemia (controls: rest 1 D. 6±0. 4, hyperaemia 2. 6±0. 2; compensated cirrhosis: rest 10. 1±0.8, hyperaemia 3.4±0.4; ascitic cirrhosis: rest 11.4±1.6, hyperaemia 2.9±0.4. Vascular reserve was 4.38±0.35 in controls, 3.33±0.39 in compensated and 4.70±0.89 in ascitic cirrhosis (p = not significant). No correlation was found between systemic haemodynamic parameters and either pulsatility index or vascular reserve. Conclusions. The lower limb vascular reserve is preserved in cirrhosis.