P0827 Pulmonary Hypertension in a Patient with Essential Thrombocythemia (original) (raw)

2009, European Journal of Internal Medicine

Introduction: A characteristic of the patients with heart failure (HF) is a decreased peripheral blood flow by rest as well as by exercise. This is caused, at least in part, by a reduced vasodilator response of the peripheral vessels endothelium. Objectives: The purpose of our study is to correlate the morphological and structural changes of the endothelium with the splanhnic blood flow, estimated by measuring the resistance index in superior mesenteric artery (RI SMA) using Doppler ultrasonography. Methods: 25 small vessels biopsies from patients that underwent abdominal surgery (15 patients with HF, 10 controls) were examined by optical and electronically microscopy. The endothelial changes were quantified by using Masuda scoring. Before intervention we measured in all patients the RI SMA and systolic peak velocity of SMA, as well as flow mediated dilation (FMD) of brachial artery. Results: we noticed very high RI SMA in patients with HF vs. controls (0.85±0,16 vs. 0.763±0,10, p<0.003), but without correlation of this index with the reactivity of the brachial artery to hyperaemia. A very low FMD (FMD 2,48±6,55 vs. 10,85±17, p<0.0001) was associated with changes of Doppler IntroductionObjectivesMaterials & MethodsResultsDiscussion & ConclusionKeywordsKeywordsflow wave pattern in SMA, namely, the lack of protodiastolic reverse. Only 9 biopsies from patients with HF have revealed important endothelial changes and a high activity score (Masuda 2-3) was correlated with low values of FMD and high peak systolic velocities in SMA. Conclusions: the correlation between FDM, endothelial structural changes and the flow wave pattern in SMA could indicate important hemodynamic disturbance and extensive endothelial dysfunction in heart failure. RI SMA, peak velocities in SMA and the Doppler flow pattern in SMA could be usefully in monitoring the peripheral circulatory status in patients with HF.