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. 2021 Apr;40(2):281-288.
doi: 10.14366/usg.20076. Epub 2020 Jul 7.

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

İlhan Hekimsoy  1 , Burçin Kibar Öztürk  2 , Hatice Soner Kemal  3 , Meral Kayıkçıoğlu  4 , Ömer Faruk Dadaş  5 , Gülgün Kavukçu  1 , Mehmet Nurullah Orman  5 , Sanem Nalbantgil  4 , Sadık Tamsel  1 , Hakan Kültürsay  4 , Süha Süreyya Özbek  1
Affiliations

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

İlhan Hekimsoy et al. Ultrasonography. 2021 Apr.

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 (LVs) and splenic shear wave velocity (SVs) 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: LVs 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 SVs 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 LVs and P=0.004 for SVs) 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.

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

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.. An example image of point shear wave elastography assessment in the right liver lobe in a 36-year-old woman with pulmonary arterial hypertension.
The region of interest was placed at a depth of 4.2 cm from the skin surface, and a shear wave velocity of 2.93 m/s was obtained.
Fig. 2.
Fig. 2.. Kaplan-Meier estimates of survival for pulmonary arterial hypertension (PAH) patients.
The mean survival time of PAH patients was calculated to be 51.9±5.4 months (95% confidence interval, 41.4 to 62.5 months).
See this image and copyright information in PMC

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