Portal hemodynamics in cirrhotics with portal hypertension using color Doppler velocity profile

Objective To investigate portal hemodynamics and its correlation with e sophageal variceal bleeding (EVB) in cirrhotics with portal hypertension by usin g a newlydeveloped technique, color Doppler velocity profile (CDVP) Methods Hemodynamics of portal trunk (PT), right anterior branch (RAB) and splenic vein (SV) were evaluated in 48 cirrhotics with portal hypertension a nd 35 normal volunteers by CDVP The parameters included maximum crosssection a l velocity (CSVmax), flow volume, congestion index (CI), profile parameter N a nd pattern of flow curve Stepwise logistic regression model was employed to de termine EVBrelating factors in cirrhotics Results CSVmax in PT and RAB was significantly lower in cirrhotic gro up than that of normal group, being 1491308?cm/s, 944270?cm/s vs 3 052 675?cm/s, 1282269?cm/s, respectively ( P <001 for both) Fl ow volume of PT and SV was significantly higher in cirrhotic group compared with that of normal group, being 25161048?mlmin1kg1, 15 8 3918?mlmin1kg1 vs 2043557?mlmin1kg 1, 581 204?mlmin1kg1, respectively ( P <001 for bo th) C I of PT,RAB and SV was significantly higher in cirrhotic group than in normal gr oup, being 014200654, 010500496, 0088400431 vs 003260014 2, 0075 700342, 0048300230, respectively ( P <001 for all) In d ynami c variation of flow volume over time, RAB and SV in cirrhotic group increasingly presented flat pattern and periodically changed pattern, respectively ( P <001 for both) Between cirrhotic subgroups without and with EVB histor y, there were significant differences in flow volume, CI and N value of SV, splenic size, degree of esophageal varices (EV) and portal hypertensive gastropathy (PH G), and stepwise logistic regression revealed that N value of SV, splenic size, degree of EV and PHG were four independent factors in relation to EVB EVB sco r es calculated from the regression equation had a close correlation with EVB I n patients with EVB score>0, 889% of them had EVB, and in those with EVB<0, 76 9% of them had no history of EVB Conclusion In cirrhotics with portal hypertension, portal venous system has the features of elevated vascular resistance and hyperdynamics, and the lat ter mainly results from increased blood flow in SV EVB score may become a val uable parameter in predicting occurrence of EVB