Application value of ultrasound in evaluating the degree of gastrointestinal wall congestion in patients with heart failure

ZHENG Ye; QIN Huai; HAO Ruyi; ZHANG Shuang; ZHAO Qing; CHEN Jie

doi:10.3969/j.issn.1674-3806.2024.07.14

Abstract：Objective To explore the application value of ultrasound in evaluating the degree of gastrointes-tinal wall congestion in patients with heart failure.Methods A total of 32 patients with heart failure who were admitted to Beijing Anzhen Hospital,Capital Medical University from August 2023 to October 2023 were recruited as the heart failure group,and 33 healthy people without heart diseases during the same period were selected as the control group.The thickness of gastric wall,the thickness of the submucosa of gastric wall and the thickness of intestinal wall,inferior vena cava diameter,hepatic vein diameter,portal vein diameter and superior mesenteric vein diameter were measured by using gastrointestinal ultrasound and abdominal ultrasound in both groups.Echocardiography was performed in the heart failure group.Left ventricular ejection fraction(LVEF),right ventricular tricuspid annular plane systolic excursion(TAPSE)and pulmonary artery systolic pressure were measured.The clinical data were compared between the two groups,and the correlation of gastrointestinal wall thickness with abdominal vein diameter and cardiac function indicators in the patients of the heart failure group was analyzed.Results The thickness of gastric wall,the thickness of the submucosa of gastric wall and the thickness of intestinal wall in the patients of the heart failure group were thicker than those in the patients of the control group,and the inferior vena cava diameter,hepatic vein diameter,portal vein diameter and superior mes-enteric vein diameter in the patients of the heart failure group were wider than those in the patients of the control group,and the differences were statistically significant(P＜0.05).In the patients of the heart failure group,LVEF was 45.5(25.0,57.7)％,and TAPSE was 16.0(11.0,18.0)mm,and pulmonary artery systolic pressure was 43.5(28.5,59.0)mmHg.In the patients of the heart failure group,gastric wall thickness was negatively correlated with TAPSE(P＜0.05)and positively correlated with portal vein diameter(P＜0.05),and the thickness of the submucosa of gastric wall was neg-atively correlated with TAPSE(P＜0.05)and positively correlated with pulmonary artery systolic pressure,inferior vena cava diameter,hepatic vein diameter and portal vein diameter(P＜0.05),and intestinal wall thickness was negatively correlated with TAPSE(P＜0.05)and positively correlated with inferior vena cava diameter,hepatic vein diameter and portal vein diameter(P＜0.05).In the patients of the heart failure group,there was no significant correlation of the gastric wall thickness,the thickness of the submucosa of gastric wall and the intestinal wall thickness with LVEF(P＞0.05).Conclusion Ultrasound can monitor the thicknesses of the gastrointestinal wall and the submucosa of gastric wall in patients with heart failure in real time,which can be used as an imaging method to evaluate the degree of gastrointestinal wall congestion in patients with heart failure.