Portacaval flow characteristics in patients with pulmonary arterial hypertension

Aim . To analyze portacaval flow by Doppler ultrasound and compare with the clinical, functional, and hemodynamic status of patients with pulmonary arterial hypertension (PAH). Material and methods . The study included 42 patients with a confirmed diagnosis of PAH, hospitalized in the Department of Pulmonary Hypertension and Heart Diseases of the Chazov National Medical Research Center of Cardiology between 2022 and 2024. Diagnosis was established according to the algorithm proposed in the Eurasian (2023) and Russian guidelines for the diagnosis and treatment of pulmonary hypertension (PH) (2024). Results . In low-risk subgroups of both PAH cohorts, results were limited to A-wave displacement relative to the QRS complex without portal flow pulsation. All high-risk idiopathic PH patients marked >50% portal flow pulsation with A-wave dominance over the S-wave in caval flow. In both groups of intermediate-risk patients and high-risk patients with systemic scleroderma, we detected cases with equal A and S waves and little pulsation of portal flow. However, this finding was not charac­teristic of all patients in these subgroups. Conclusion . The obtained data confirm a correlation between the severity of venous stasis and risk degree in patients with PAH. The results also indicate the potential of non-invasive assessment of central venous pressure and portocaval pressure gradient using portocaval hemodynamic parameters in patients with right ventricular failure.