P675 ECHO COLOR DOPPLER EVALUATION OF SPLANCHNIC HEMODYNAMIC DURING ACUTE HEART FAILURE

Abstract BACKGROUND Acute heart failure (AHF) seems to provoke profound derangement of abdominal hemodynamic, which causes symptoms and impacts on renal function. METHODS 27 patients (10 F - age 78 - EF 0.39) admitted for AHF underwent cardiac and abdominal ultrasound at day 1 and 5. Arterial and venous flow within liver, spleen and kidney were recorded. Portal and Splenic Vein flow was described as continuous, pulsatile or reversed, whereas hepatic vein systolic and diastolic ratio was measured. Renal Venous Doppler Profile (VDP) was classified as: continuous, pulsatile, biphasic or monophasic. Arterial Resistive Index (RI) ≥0.7 was considered elevated. OUTCOME At day 1 most patients presented with some degree of deranged VDP and high RI in all examined organs. At day 5, a significant proportion of patients improved their VDP in Liver, Kidney and Spleen, while the percentage of patients with collapsing IVC did not significantly change. On the arterial side, the proportion of patients with high Hepatic RI dropped significantly. CONCLUSIONS Our preliminary data show that most deranged VDP in abdominal organs and Hepatic RI improve after decongestion despite a nonsignificant trend in improvement in IVC profile. RESULTS Classification day 1 day 5 p IVC Collapsing 24% 34% ns Portal Vein Continous 22% 50% Pulsatile 72% 50% Reversed 6% 0% <.05* Hepatic Vein S/D≥1 24% 59% S/D <1 60% 28% Reversed S 16% 14% <.05* Hepatic Artery RI ≥0.7 87% 36% <.05 Splenic Vein Flat 28% 57% Pulsatile 56% 33% Reversed 16% 10% <.05* Splenic Artery RI ≥ 0.7 52% 48% ns Renal Vein Continous 11% 39% Pulsatile/Biphasic 52% 52% Monophasic 37% 9% <.05* Renal Artery RI ≥0.7 63% 65% ns * Refers to normal profile versus all other deranged profiles

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P2599Echo color doppler evaluation of renal hemodynamic during acute heart failure

European Heart Journal ◽

10.1093/eurheartj/ehz748.0924 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Sacchi ◽

M Galassi ◽

F Brugioni ◽

B Ricco' ◽

F Lami ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Color Doppler ◽

Diuretic Therapy ◽

Systolic Pressure ◽

Resistive Index ◽

Kidney Injury ◽

Pulmonary Artery Systolic Pressure ◽

Venous Flow ◽

Renal Hemodynamic

Abstract Background Acute heart failure (AHF) is often accompanied by impairment in renal function. A profound derangement of normal abdominal haemodynamic is always present during this clinical phase. Methods 14 patients (6 F – mean age 80 – mean EF 0.39) admitted for acute heart failure underwent cardiac and renal Echo Doppler examination at day 1-3-5 of Hospital stay. Parameters of arterial and venous flow within cortical right kidney were recorded. Venous Doppler Profile (VDP) was classified as: continuous (C), pulsatile (P), biphasic (B) or monophasic (M) according to the growing degree of derangement. Arterial resistive index (RI) >0.8 was considered elevated. Correlation between renal hemodynamic (and its changes) with biohumoral and echo parameters was sought. Outcome At day 1 VDP was M or B in 8 patients (57%) and in four (50%) of them dropped to C or P at day 5. RI was elevated in 8 patients at day 1 while only in 4 at day 5. VDP and RI were not related to EF or BNP values. One patient died before day 5, no other worsening heart failure episodes occurred. Two patients (14%) developed acute kidney injury but their VDP and RI were normal and did not change. Three patients (21%) did not improve their BNP (decrease >30%) but this was not associated with VDP or RI changes. Elevated derived pulmonary artery systolic pressure (>40 mmHg) was present in 6 out of 8 patients (75%) with M or B VDP and in all 4 patients with both elevated RI and M or B VDP. Venous Pattern Day 1 Day 3 Day 5 Continous 2 8 5 Pulsatile 4 2 4 Biphasic 2 1 2 Monophasic 6 3 2 Arterial RI >0.8 8 6 4 BNP, pg/ml 1060±1180* 372±281* 424±213* Creatinine, mg/dl 1.4±0.6 1.5±0.6 1.3±0.6 Hb, g/dl 12.1±2.3 12.3±3.6 13.2±2.3 *p>0.05. Conclusions This is the first study exploring changes in renal hemodynamic by echo Doppler during AHF. With respect to previous studies among stable patients, our preliminary data shows a higher proportion of deranged renal venous and/or arterial pattern. After diuretic therapy a trend towards improvement in VDP was recorded. No clear association with other clinical and hemodynamic parameters seems evident.

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Loss of apical suction assessed by noninvasive pressure differences and twist in acute heart failure: a novel method using vector flow mapping

European Heart Journal ◽

10.1093/eurheartj/ehab724.0150 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

S Ido ◽

K Masuda ◽

S Yoshimura ◽

H Tanaka ◽

M Stugaard

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Diastolic Pressure ◽

Color Doppler ◽

Left Ventricular ◽

Frame Rate ◽

Flow Mapping ◽

Vector Flow Mapping ◽

Funding Sources ◽

Novel Method

Abstract Background Early diastolic intraventricular pressure difference (IVPD) reflects left ventricular (LV) apical suction, and IVPD is closely related to cardiac function, especially LV twist. Vector Flow Mapping (VFM) allows visualization of regional pressure distribution and noninvasive quantification of IVPD. The purpose of the present study was to investigate if and how IVPDs are related to LV twist in a model of acute heart failure (HF). Methods In 15 open-chest dogs, HF was induced by intracoronary injection of microspheres. The HF model was classified into two groups based on the LV end-diastolic pressure (LVEDP) (group1: LVEDP<18 mmHg (n=10), group2: LVEDP≥18 mmHg (n=8)). Color Doppler images from apical long-axis views were acquired at baseline and during HF. From these images, pressure differences (ΔP) were calculated along the LV inflow tract throughout the cardiac cycle. For the purpose of this study, the differences between apex and base during isovolumic relaxation time (ΔPIRT) and rapid early inflow period (ΔPE) were used for analyses. Furthermore, apical and basal short axis high frame rate 2D images were acquired, and peak rotation and peak twist were analyzed. Results LVEDP was 7±9, 14±2, 21±3 mmHg for baseline, group1 HF, and group2 HF, respectively. Pressure differences (both ΔPIRT and ΔPE) were visibly changed by the increase of LVEDP (Figure), and the magnitude of ΔPIRT, ΔPE and peak twist decreased significantly with the severity of heart failure. There were significant relationships between pressure differences (ΔPIRT and ΔPE) and dP/dtmin, tau, EF and peak twist (Table). In multivariate analyses, tau and peak twist were independent predictors for ΔPIRT and peak twist was independent predictor for ΔPE. Conclusion VFM analysis is feasible to noninvasively assess the IVPDs in acute heart failure. The IVPDs are closely related to the twisting motion of the LV, and reflect loss of apical suction during severe HF. FUNDunding Acknowledgement Type of funding sources: None. VFM images of pressure differences Correlations of pressure differences

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Renal resistive index changes in a murin acute heart failure model

Archives of Cardiovascular Diseases Supplements ◽

10.1016/j.acvdsp.2019.02.108 ◽

2019 ◽

Vol 11 (2) ◽

pp. 230-231

Author(s):

B. Deniau ◽

P.R. Koundé ◽

P. Bonnin ◽

J.L. Samuel ◽

A. Mebazaa ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Resistive Index ◽

Renal Resistive Index ◽

Failure Model ◽

Index Changes ◽

Heart Failure Model

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48 Transrectal color Doppler evaluation of umbilicus, placentomes, and uterine vascularity changes throughout pregnancy in Surti buffalo

Reproduction Fertility and Development ◽

10.1071/rdv32n2ab48 ◽

2020 ◽

Vol 32 (2) ◽

pp. 149

Author(s):

M. Gaur ◽

G. N. Purohit

Keyword(s):

Blood Flow ◽

Pulsatility Index ◽

Uterine Artery ◽

Color Doppler ◽

Resistive Index ◽

Flow Mode ◽

Adult Age ◽

Uterine Arteries ◽

Doppler Evaluation ◽

Surti Buffalo

With an objective to record the appearance, vascularity changes in umbilicus, placentomes, and blood flow to the uterus, adult (age 5-10 yr) Surti buffalo (parity=2-6; n=24) were inseminated during natural oestrus during the breeding season and scanned by transrectal B mode and colour flow mode ultrasonography every 3-4 days till Day 90 of gestation and then at an interval of 15 days for the complete gestation. The umbilical cord was first visible on Day 38; however, colour Doppler wave fronts could first be obtained on Day 46, which became increasingly distinct thereafter. The placentomes could first be identified at Day 76 of gestation. The placentome diameters increased from Day 76 until the month 7 with significant increases (P<0.05) during Day 80, and months 4, 5, and 6 of gestation; thereafter, the increase was not significant. The vascularity of placentomes could also be recognised at Day 76 and this increased with increasing months of gestation. The blood flow to the middle uterine arteries could be identified after month 2 of gestation. The resistive index values of the middle uterine artery ipsilateral to the gravid horn showed an almost linear decline with a significant (P<0.05) drop at months 4 and 9 of gestation. Similarly, resistive index values of the middle uterine artery contra-lateral to the gravid horn revealed a significant (P<0.05) decrease on month 3, 5, and 6. A significant decrease for pulsatility index values of the middle uterine artery ipsilateral to the gravid horn was observed in months 3, 6, and 8 of gestation. However, the pulsatility index values for the middle uterine artery contralateral to the gravid horn showed a nonsignificant decrease. It was concluded that the umbilicus and placentomes are first visible at 38 and 76 days of gestation and the vascularity of the umbilicus, placentomes, and middle uterine artery increases with advancement of gestation in Surti buffalo.

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