Ultrasonography.  2021 Apr;40(2):281-288. 10.14366/usg.20076.

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

• Hekimsoy
• Kibar Öztürk B
• Soner Kemal H
• Kayıkçıoğlu M
• Dadaş
• Kavukçu G
• Orman MN
• Nalbantgil S
• Tamsel S
• Kültürsay H
• Özbek SS

• KMID: 2514014
• DOI: http://doi.org/10.14366/usg.20076

Abstract

Purpose
The aim of this study was to evaluate the associations of sonographic and sonoelastographic parameters with clinical cardiac parameters, as well as to assess their value in predicting survival in patients with pulmonary arterial hypertension (PAH).
Methods
Thirty-six patients with PAH and normal liver function were prospectively enrolled in this prospective study along with 26 healthy controls, all of whom underwent ultrasound and point shear wave elastography examinations. Additionally, the portal vein pulsatility index (PVPI), inferior vena cava collapsibility index, and clinical cardiac variables were obtained in PAH patients. The values of hepatic (LV_s) and splenic shear wave velocity (SV_s) were compared between PAH patients and controls. The relationships between all sonographic and clinical parameters in the PAH patients were analyzed. Furthermore, their prognostic value in predicting survival was investigated.
Results
LV_s values in PAH patients (median, 1.62 m/s) were significantly higher than in controls (median, 0.99 m/s), while no significant difference was observed in SV_s values. Patients with higher grades of tricuspid regurgitation (TR) had significantly different values of PVPI (P=0.010) and sonoelastographic parameters (P<0.001 for LV_s and P=0.004 for SV_s) compared to those with less severe TR. Tricuspid annular plane systolic excursion values were the only investigated parameter found to be associated with survival (hazard ratio, 0.814; 95% confidence interval, 0.694 to 0.954; P=0.011).
Conclusion
Our results demonstrated a direct association between cardiac congestion (i.e., the severity of TR) and liver stiffness, which should be kept in mind during the assessment of fibrosis in patients with PAH.

Keyword

Congestion; Pulmonary arterial hypertension; Shear wave elastography; Elasticity imaging techniques; Stiffness