Conclusions
The findings of this study showed that Doppler echocardiographic parameters of the middle hepatic vein could be helpful in detecting PHTN .This was due to the effect of PHTN on A wave and the resultant changes in the relationship between A and S wave. Therefore, A/S is increased to values greater than 1 in PHTN, while the A/S values were smaller than 1 in patients with normal PAP. A wave velocity and duration were found to be related to PHTN in PHTN patients with and without RV dysfunction. HV systolic filling fraction more than 0.535 was a sensitive parameter in detecting normal PAP, therefore; HV systolic fraction index can be used as a screening echocardiographic parameter in ruling out PHTN.