Peripheral Venous Pressure Measurements to Evaluate Congestion in Heart Failure

Maruichi-Kawakami, Shiori; Nagao, Keisuke; Aida, Kenji; Matsuto, Kenichi; Imamoto, Kazumasa; Tamura, Akinori; Takazaki, Tadashi; Nakatsu, Taro; Tanaka, Masaru; Nakayama, Shogo; Morimoto, Takeshi; Kimura, Takeshi; Inada, Tsukasa

doi:10.1016/j.cardfail.2021.11.018

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Furthermore, PVP was found to be a better predictor of RAP compared with echocardiographic assessment of inferior vena cava diameter in a previous study. 17 …”

Section: Discussionmentioning

confidence: 99%

“…Thereafter, PVP was measured at end‐expiration. 14 , 17 To avoid additional punctures solely for the purposes of the present study, we measured PVP mainly via a 22‐G peripheral IV cannula placed in the upper extremity as the IV access route or for blood drawing for routine laboratory tests. 20 Details on PVP measurements are provided in Data S1 .…”

Section: Methodsmentioning

confidence: 99%

“… 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 Recent studies have also demonstrated a robust association between PVP and RAP or central venous pressure obtained through right heart catheterization (RHC) in patients with heart failure (HF), cardiac transplant, Fontan circulation, and patients with left ventricular (LV) assist device. 14 , 15 , 16 , 17 , 18 , 19 PVP has been shown to have superior predictive capabilities for RAP compared with conventional bedside examinations, including physical examinations, laboratory tests, and imaging modalities. 17 Moreover, in hospitalized patients with AHF, PVP has been shown to be associated with adverse postdischarge outcomes.…”

mentioning

confidence: 99%

“… 14 , 15 , 16 , 17 , 18 , 19 PVP has been shown to have superior predictive capabilities for RAP compared with conventional bedside examinations, including physical examinations, laboratory tests, and imaging modalities. 17 Moreover, in hospitalized patients with AHF, PVP has been shown to be associated with adverse postdischarge outcomes. 20 Importantly, PVP measurement, unlike RHC, is minimally invasive and can be performed at the bedside.…”

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confidence: 99%

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Association Between the Liver Fibrosis Markers and Scores, and Hemodynamic Congestion Assessed by Peripheral Venous Pressure in Patients With Acute Heart Failure

Nagao,

Maruichi‐Kawakami,

Aida

et al. 2023

JAHA

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Background Peripheral venous pressure (PVP) has been shown to be a reliable surrogate for right atrial pressure in assessing congestion in patients with heart failure (HF). Liver fibrosis markers and scores can be useful in assessing organ injury in patients with acute HF. This study aimed to investigate the association of liver fibrosis markers and scores with PVP in patients with acute HF. Methods and Results The 7S domain of the collagen type IV N‐terminal propeptide (P4NP 7S), aspartate aminotransferase‐to‐platelet ratio index, fibrosis‐4, and nonalcoholic fatty liver disease fibrosis score were determined along with PVP measurements before discharge in 229 patients with acute HF. The strongest correlation with PVP was found for P4NP 7S (Pearson r =0.40). Patients with high P4NP 7S levels (≥median [6.2 ng/mL]) had an increased risk of cardiovascular death or HF hospitalization (adjusted hazard ratio [HR], 1.80 [95% CI, 1.09–3.04], P =0.02). The concomitant high PVP (≥mean [8 mm Hg])/high P4NP 7S group, in contrast to the high PVP/low P4NP 7S or low PVP/high P4NP 7S group, had a significant risk relative to the low PVP/low P4NP 7S group for cardiovascular death or HF hospitalization (adjusted HR, 2.63 [95% CI, 1.43–5.05], P =0.002). A sustained elevation in PVP for 1 month postdischarge was associated with a persistent increase in P4NP 7S. Conclusions The study demonstrated the relationship between the liver fibrosis marker P4NP 7S and congestion. PVP and P4NP 7S could be useful for assessing congestion‐related organ injury and predicting prognosis in patients with acute HF.

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“…Furthermore, PVP was found to be a better predictor of RAP compared with echocardiographic assessment of inferior vena cava diameter in a previous study. 17 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Association Between the Liver Fibrosis Markers and Scores, and Hemodynamic Congestion Assessed by Peripheral Venous Pressure in Patients With Acute Heart Failure

Nagao,

Maruichi‐Kawakami,

Aida

et al. 2023

JAHA

Self Cite

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Prognostic implications of post-discharge hemodynamic congestion assessed by peripheral venous pressure among patients discharged from acute heart failure

Matsuto

Maruichi-Kawakami

Aida

et al. 2023

International Journal of Cardiology

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Association of peripheral venous pressure with adverse post-discharge outcomes in patients with acute heart failure: a prospective cohort study

Nagao

Maruichi-Kawakami

Aida

et al. 2022

European Heart Journal. Acute Cardiovascular Care

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Aims Congestion is the major cause of hospitalization for heart failure (HF). Traditional bedside assessment of congestion is limited by insufficient accuracy. Peripheral venous pressure (PVP) has recently been shown to accurately predict central venous congestion. We examined the association between PVP before discharge and post-discharge outcomes in hospitalized patients with acute HF. Methods and results Bedside PVP measurement at the forearm vein and traditional clinical examination were performed in 239 patients. The association with the primary composite endpoint of cardiovascular death or HF hospitalization and the incremental prognostic value beyond the established HF risk score was examined. The PVP correlated with peripheral oedema, jugular venous pressure, and inferior vena cava diameter, but not with brain-type natriuretic peptide. The 1-year incidence of the primary outcome measure in the first, second, and third tertiles of PVP was 21.4, 29.9, and 40.7%, respectively (log-rank P = 0.017). The adjusted hazard ratio of PVP per 1 mmHg increase for the 1-year outcome was 1.08 [95% confidence interval (1.03–1.14), P = 0.004]. When added onto the Meta-Analysis Global Group in Chronic HF risk score, PVP significantly increased the area under the receiver-operating characteristic curve for predicting the outcome [from 0.63 (0.56–0.71) to 0.70 (0.62–0.77), P = 0.02), while traditional assessments did not. The addition of PVP also yielded significant net reclassification improvement [0.46 (0.19–0.74), P < 0.001]. Conclusion The PVP at discharge correlated with prognosis. The results warrant further investigation to evaluate the clinical application of PVP measurement in the care of HF. Trial registration number UMIN000034279

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Peripheral Venous Pressure Measurements to Evaluate Congestion in Heart Failure

Cited by 3 publications

References 8 publications

Association Between the Liver Fibrosis Markers and Scores, and Hemodynamic Congestion Assessed by Peripheral Venous Pressure in Patients With Acute Heart Failure

Association Between the Liver Fibrosis Markers and Scores, and Hemodynamic Congestion Assessed by Peripheral Venous Pressure in Patients With Acute Heart Failure

Prognostic implications of post-discharge hemodynamic congestion assessed by peripheral venous pressure among patients discharged from acute heart failure

Association of peripheral venous pressure with adverse post-discharge outcomes in patients with acute heart failure: a prospective cohort study

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