Purpose: To explore which parameters of hepatic vein Doppler (HVD) are correlated with echocardiographic findings of tricuspid regurgitation (TR) following liver transplantation (LT)
Materials and Methods: Thirty-six consecutive patients (21 men and 15 women; mean age, 49.4 years) who underwent echocardiography after LT from January 2006 to July 2007 were included. The records of echocardiography were searched for TR grade and peak velocity of TR flow. HVD parameters were particularly evaluated for peak velocity of retrograde flow (R), peak velocity of antegrade flow (A), difference between R and A (R-A), the ratio of R to A (R/A ratio), and modified R/A ratio, the product of R/A ratio and ratio of retrograde to antegrade flow duration. Correlation test and receiver operating characteristic analysis for comparison of accuracy of these parameters and decision of optimal cutoff of each HVD parameter to diagnose moderate and severe TR were performed.
Results: TR grade was best correlated with modified R/A ratio (rho=0.585), followed by R/A ratio (rho=0.503) and R (rho=0.455). Modified R/A ratio was the best accurate parameter for the diagnosis of moderate and severe TR (Az=0.825 and 0.895, respectively), and its optimal cutoff was 0.11 for ≥ moderate TR (sensitivity and specificity both 77.78%) and 0.13 for severe TR (sensitivity, 100%; specificity, 81.2%).
Conclusion: Modified R/A ratio is the parameter best correlated with echocardiographic results of TR, though the correlation strength is only moderate. Additionally, modified R/A ratio is an accurate HVD parameter for diagnosis of moderate and severe TR in patients following LT.