Doppler Study to Evaluate the Effect on Venous Flow of Decubitus
Objectives: To determine the decubitus for sleep where venous return would have more forward velocity, the venous flow changes were traced in the Middle Hepatic Vein (MHV) of healthy adults in the right, left and supine recumbent positions by Doppler Sonography.
Methods: Total 330 MHV Doppler tracings including 110 for each of the studied decubital (right, left and supine) positions were obtained on 110 fasted healthy adults of both gender. Each MHV Doppler spectrums was analyzed for the magnitude of its forward and backward flow velocity components and then accordingly, the spectrum was scored into HV0, HV1 or HV2 grades. The ratio of flow velocity components and caliber of MHV were also calculated. Statistical significant difference (S.S.D.) of the percentage of HV0, HV1 and HV2 grades correlated with the studied recumbent positions were evaluated by the fisher’s exact test while S.S.D. for velocity’ variables of forward and backward flow velocity waves correlated with the studied decubital positions, age, gender, heart rate, weight, height, body mass index and martial status of the participants were estimated by the chi-square test.
Results: 100, 82 and 77 percent of MHV Doppler spectrums in right, left and supine recumbent positions respectively were found of grade Hvo. The result related to comparison of these waves and calibration of MHV in the studied decubital positions revealed that in the right decubitus: the forward flow velocity component (S) were of comparatively high and uniform amplitude along with > 1 S : D ratio; “a” wave (back flow velocity) comparatively was of smaller amplitude and calibration of MHV was only here < 10 mm (i.e. normal). The Statistical significant difference (S.S.D.) evaluated for HV0, HV1 and HV2 grades percentage correlated with the studied decubital positions except of right recumbent were highly significant (p < 0.005). The S.S.D. of ratios of forward and backward velocities’ variables correlated with the studied decubital positions except of right recumbent were of also significant (p < 0.001). The S.S.D. of the velocity variables in relation to age, gender, heart rate, height, weight, body mass index and marital status of the subjects in all studied recumbent positions were not significant.
Conclusions: Among the right, left and supine decubital positions of healthy adults, it is the right decubitus where venous return to the heart is more and maximum because its all multiphasic MHV spectrums are characterized with: the comparatively more high forward velocity flow wave; low velocity of back flow wave and calibration of MHV < 10 mm (normal size.
Abbreviations: MHV - Middle hepatic vein, S.S.D. - Statistical Significant Difference.
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