ABSTRACT
Background: Portal hypertension is a serious complication of liver cirrhosis. Doppler ultrasound assessment may be a non-invasive and cost-effective means of evaluating portal hemodynamics in patients with portal hypertension
Aims and objectives: To assess efficacy of Doppler ultrasound in detecting changes in hemodynamics of hepatic circulation after beta-blocker administration
Methodology: 11 patients with liver cirrhosis and portal hypertension were included. All underwent Doppler assessment of portal vein velocity [PVV], spleno-portal index [SPI], congestive index [CI], liver vascular index [LVI], dampening index [DI], hepatic artery velocity [HAV], splenic artery velocity [SAV], hepatic artery resistive index [HARI] and splenic artery resistive index [SARI]. They were started on beta-blocker carvedilol 6.25 mg once daily and recalled after two weeks for repeat assessment
Results: Out of 13 enrolled, 4 were lost to follow up and one stopped carvedilol. 8 remained. The changes in parameters were: PVV: reduction in 3 [37.5%], no change in 1 and increase in 4[50%] patients; SPI: reduction in 3 [37.5%] and increase in 5 [62.5%]; CI: reduction in 3 [37.5%], no change in 1 and increase in 4 [50%]; LVI: decrease in 3 [50%], no change in 1 and increase in 2; DI: decrease in 5 [62.5%] and increase in 3 [37.5%]; HAV: increase in 4 [50%], no change in 1 [12.5%] and decrease in 3 [37.5%]; SAV: decrease in 4 [50%] and increase in 4 [50%]; HARI: increase in 7 [87.5%] and decrease in 1 [12.5%]; SARI: reduction in 3 [37.5%] and increase in 3 [37.5%]. 3 patients achieved reduction in 5 [PVV, LVI, DI, SARI and SAV] parameters. DI had the largest number of patients with observable reduction and HARI with the largest number showing observable increase in measured parameters
Conclusion: Doppler ultrasound represents a cost effective means of assessing the hemodynamics of hepatic circulation and any associated changes due to diseases and drugs