Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis

A prospective nonrandomized study

Moon Young Kim, Soon Koo Baik, Dong Hun Park, Dae Wook Lim, Jae Woo Kim, Hyun Soo Kim, Sang Ok Kwon, Young Ju Kim, Sei Jin Chang, Samuel S. Lee

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background and Aims: Alterations in the Doppler hepatic vein (HV) waveform are associated with cirrhosis and portal hypertension. We prospectively evaluated the correlation between the extent of abnormal Doppler HV waveforms expressed as damping index (DI) and the hepatic venous pressure gradient (HVPG) and response to propranolol in patients with cirrhosis. Material and Methods: In 76 patients with cirrhosis (69 men and seven women), both DI of Doppler HV waveform and HVPG were measured, and the relationship between them was analysed. DI was calculated by the minimum velocity/maximum velocity of the HV waveform. An HVPG > 12 mmHg was defined as severe portal hypertension. In a subgroup of 19 patients receiving propranolol, changes in both DI and HVPG were evaluated after propranolol administration for 3 months. One author (S. K. B.) performed all DI of Doppler HV waveform studies. Results: Abnormal HV waveforms were seen in 66 of 76 patients (86.8%). DI significantly correlated with the grade of HVPG, i.e. with higher HVPG increased DI was observed (P < 0.01). By logistic regression analysis, DI>0.6 was significantly more likely to be severe portal hypertension (odds ratio: 14.19, 95% confidence interval: 4.07-49.55). Receiver-operating characteristic curve according to the value of 0.6 of DI showed a sensitivity of 75.9% and a specificity of 81.8% for the presence of severe portal hypertension. In 19 patients of the propranolol subgroup, change of DI following propranolol treatment also significantly correlated with that of HVPG (P < 0.01). Conclusions: Damping index of the HV waveform by Doppler ultrasonography might be a non-invasive supplementary tool in evaluating the severity of portal hypertension and in responding to propranolol in patients with liver cirrhosis.

Original languageEnglish
Pages (from-to)1103-1110
Number of pages8
JournalLiver International
Volume27
Issue number8
DOIs
Publication statusPublished - 2007 Oct 1

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Venous Pressure
Hepatic Veins
Portal Hypertension
Propranolol
Liver Cirrhosis
Prospective Studies
Liver
Fibrosis
Doppler Ultrasonography
ROC Curve
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Kim, Moon Young ; Baik, Soon Koo ; Park, Dong Hun ; Lim, Dae Wook ; Kim, Jae Woo ; Kim, Hyun Soo ; Kwon, Sang Ok ; Kim, Young Ju ; Chang, Sei Jin ; Lee, Samuel S. / Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis : A prospective nonrandomized study. In: Liver International. 2007 ; Vol. 27, No. 8. pp. 1103-1110.
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title = "Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis: A prospective nonrandomized study",
abstract = "Background and Aims: Alterations in the Doppler hepatic vein (HV) waveform are associated with cirrhosis and portal hypertension. We prospectively evaluated the correlation between the extent of abnormal Doppler HV waveforms expressed as damping index (DI) and the hepatic venous pressure gradient (HVPG) and response to propranolol in patients with cirrhosis. Material and Methods: In 76 patients with cirrhosis (69 men and seven women), both DI of Doppler HV waveform and HVPG were measured, and the relationship between them was analysed. DI was calculated by the minimum velocity/maximum velocity of the HV waveform. An HVPG > 12 mmHg was defined as severe portal hypertension. In a subgroup of 19 patients receiving propranolol, changes in both DI and HVPG were evaluated after propranolol administration for 3 months. One author (S. K. B.) performed all DI of Doppler HV waveform studies. Results: Abnormal HV waveforms were seen in 66 of 76 patients (86.8{\%}). DI significantly correlated with the grade of HVPG, i.e. with higher HVPG increased DI was observed (P < 0.01). By logistic regression analysis, DI>0.6 was significantly more likely to be severe portal hypertension (odds ratio: 14.19, 95{\%} confidence interval: 4.07-49.55). Receiver-operating characteristic curve according to the value of 0.6 of DI showed a sensitivity of 75.9{\%} and a specificity of 81.8{\%} for the presence of severe portal hypertension. In 19 patients of the propranolol subgroup, change of DI following propranolol treatment also significantly correlated with that of HVPG (P < 0.01). Conclusions: Damping index of the HV waveform by Doppler ultrasonography might be a non-invasive supplementary tool in evaluating the severity of portal hypertension and in responding to propranolol in patients with liver cirrhosis.",
author = "Kim, {Moon Young} and Baik, {Soon Koo} and Park, {Dong Hun} and Lim, {Dae Wook} and Kim, {Jae Woo} and Kim, {Hyun Soo} and Kwon, {Sang Ok} and Kim, {Young Ju} and Chang, {Sei Jin} and Lee, {Samuel S.}",
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Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis : A prospective nonrandomized study. / Kim, Moon Young; Baik, Soon Koo; Park, Dong Hun; Lim, Dae Wook; Kim, Jae Woo; Kim, Hyun Soo; Kwon, Sang Ok; Kim, Young Ju; Chang, Sei Jin; Lee, Samuel S.

In: Liver International, Vol. 27, No. 8, 01.10.2007, p. 1103-1110.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis

T2 - A prospective nonrandomized study

AU - Kim, Moon Young

AU - Baik, Soon Koo

AU - Park, Dong Hun

AU - Lim, Dae Wook

AU - Kim, Jae Woo

AU - Kim, Hyun Soo

AU - Kwon, Sang Ok

AU - Kim, Young Ju

AU - Chang, Sei Jin

AU - Lee, Samuel S.

PY - 2007/10/1

Y1 - 2007/10/1

N2 - Background and Aims: Alterations in the Doppler hepatic vein (HV) waveform are associated with cirrhosis and portal hypertension. We prospectively evaluated the correlation between the extent of abnormal Doppler HV waveforms expressed as damping index (DI) and the hepatic venous pressure gradient (HVPG) and response to propranolol in patients with cirrhosis. Material and Methods: In 76 patients with cirrhosis (69 men and seven women), both DI of Doppler HV waveform and HVPG were measured, and the relationship between them was analysed. DI was calculated by the minimum velocity/maximum velocity of the HV waveform. An HVPG > 12 mmHg was defined as severe portal hypertension. In a subgroup of 19 patients receiving propranolol, changes in both DI and HVPG were evaluated after propranolol administration for 3 months. One author (S. K. B.) performed all DI of Doppler HV waveform studies. Results: Abnormal HV waveforms were seen in 66 of 76 patients (86.8%). DI significantly correlated with the grade of HVPG, i.e. with higher HVPG increased DI was observed (P < 0.01). By logistic regression analysis, DI>0.6 was significantly more likely to be severe portal hypertension (odds ratio: 14.19, 95% confidence interval: 4.07-49.55). Receiver-operating characteristic curve according to the value of 0.6 of DI showed a sensitivity of 75.9% and a specificity of 81.8% for the presence of severe portal hypertension. In 19 patients of the propranolol subgroup, change of DI following propranolol treatment also significantly correlated with that of HVPG (P < 0.01). Conclusions: Damping index of the HV waveform by Doppler ultrasonography might be a non-invasive supplementary tool in evaluating the severity of portal hypertension and in responding to propranolol in patients with liver cirrhosis.

AB - Background and Aims: Alterations in the Doppler hepatic vein (HV) waveform are associated with cirrhosis and portal hypertension. We prospectively evaluated the correlation between the extent of abnormal Doppler HV waveforms expressed as damping index (DI) and the hepatic venous pressure gradient (HVPG) and response to propranolol in patients with cirrhosis. Material and Methods: In 76 patients with cirrhosis (69 men and seven women), both DI of Doppler HV waveform and HVPG were measured, and the relationship between them was analysed. DI was calculated by the minimum velocity/maximum velocity of the HV waveform. An HVPG > 12 mmHg was defined as severe portal hypertension. In a subgroup of 19 patients receiving propranolol, changes in both DI and HVPG were evaluated after propranolol administration for 3 months. One author (S. K. B.) performed all DI of Doppler HV waveform studies. Results: Abnormal HV waveforms were seen in 66 of 76 patients (86.8%). DI significantly correlated with the grade of HVPG, i.e. with higher HVPG increased DI was observed (P < 0.01). By logistic regression analysis, DI>0.6 was significantly more likely to be severe portal hypertension (odds ratio: 14.19, 95% confidence interval: 4.07-49.55). Receiver-operating characteristic curve according to the value of 0.6 of DI showed a sensitivity of 75.9% and a specificity of 81.8% for the presence of severe portal hypertension. In 19 patients of the propranolol subgroup, change of DI following propranolol treatment also significantly correlated with that of HVPG (P < 0.01). Conclusions: Damping index of the HV waveform by Doppler ultrasonography might be a non-invasive supplementary tool in evaluating the severity of portal hypertension and in responding to propranolol in patients with liver cirrhosis.

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