Fig. 25.

a The PV waveform typically exhibits a continuous pattern with limited pulsatility and a normal PVPF (< 30%) due to hepatic sinusoids that attenuate the linear transmission of RAP. b In mild to moderate venous congestion, characterized by elevated RAP and RV dysfunction, the PVPF may rise above 30% but remain below 50%. c A PVPF exceeding 50%, with or without systolic flow reversal (below the baseline), indicates severe congestion. PV, portal vein; PVPF, portal vein pulsatility fraction; RAP, right atrial pressure; RV, right ventricle