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Abstract Heart failure is a complex syndrome with multiple organ manifestations. Extracardial organ damage (kidney, liver, lung, and skeletal muscle) present typically in the advanced stages of chronic heart failure. Liver disorders in chronic heart failure result from either congestion and/or hypo perfusion. Regional or systemic neurohormonal activation may also play a role in liver dysfunction in chronic or acute heart failure. Liver damage in heart failure is manifested by hepatomegaly and subicterus, especially in cases where right-heart failure is present. In patients with acute heart failure and a low cardiac index, liver transaminases rise significantly as a manifestation of ischemic hepatitis. There are unique changes of portal vein flow in heart failure. The portal vein is interposed between the capillary net- work of splanchnic circulation and hepatic sinusoids.The portal vein is easily accessible for ultrasound examination and its flow can be analyzed using Doppler. Liver congestion causes transmission of flow waveforms portal vein. measurement of portal flow is a good tool for detection and quantification of systemic congestion. In our study we investigated the changes of the portal vein flow in patients with an acute exacerbation of heart failure in relation to right atrial pressure and biochemical indicators of liver lesion.we investigated 30 patients with chronic heart failure with exacerbation presented at heart failure unit at National Heart Institute for evaluation of heart failure condition. The diagnosis of heart failure was based on a combination of physical examination, laboratory tests, and imaging. summary 113 In our study we found that in pure cardiac liver disease the PV flow becomes pulsatile. In our study We found that there was significant correlation between pulsatility index (PI) and elevated level of serum total bilirubin (p. value was 0.013). In our study We found that although serum amino transferases (ALT , AST ) and alkaline phosphatase were elevated there was no significant correlation between pulsatility index (PI) and elevated level of serum amino transferases(p value= 0.283). and alkaline phosphatase . (p value= 0.308). In our study We found that although serum albumin level was declined but there was no significant correlation between pulsatility index (PI) and In our study We found that although INR mildly elevated there was no significant correlation between pulsatility index (PI) and elevated level of INR. (p value= 0. 0.066). In our study We found that there was significant correlation between pulsatility index (PI) and right atrial pressure (p. value was 0.01). In our study We found that there was significant correlation between pulsatility index (PI) and tricuspid regurge (p. value was 0.0.044). In our study We found that there was significant correlation between pulsatility index (PI) and severity of heart failure determined by using NYHA classification (p. value was 0.021) |