Precision of Echocardiographic Estimates of Right Atrial Pressure in Patients with Acute Decompensated Heart Failure

Tsutsui, Rayji; Borowski, Allen G.; Tang, W.H. Wilson; Thomas, James D.; Popović, Zoran B.

doi:10.1016/j.echo.2014.06.002

Cited by 37 publications

(32 citation statements)

References 25 publications

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“…IVC diameter has been shown to increase after fluid resuscitation and in association with concomitant increases in CVP [21]. Additionally, although the precision of IVC-derived estimation of CVP may be reduced in heart failure, serial assessment can be performed in patients with decompensated heart failure in order to guide management [22]. This simple parameter, easily measurable at the point of care, has been found to offer as much precision as more complex estimates involving more variables [22].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure

Ciozda

Kedan

Kehl³

et al. 2015

Cardiovasc Ultrasound

139

116

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BackgroundCentral venous pressure (CVP) and right atrial pressure (RAP) are important parameters in the complete hemodynamic assessment of a patient. Sonographic measurement of the inferior vena cava (IVC) diameter is a non-invasive method of estimating these parameters, but there are limited data summarizing its diagnostic accuracy across multiple studies. We performed a comprehensive review of the existing literature to examine the diagnostic accuracy and clinical utility of sonographic measurement of IVC diameter as a method for assessing CVP and RAP.MethodsWe performed a systematic search using PubMed of clinical studies comparing sonographic evaluation of IVC diameter and collapsibility against gold standard measurements of CVP and RAP. We included clinical studies that were performed in adults, used current imaging techniques, and were published in English.ResultsTwenty one clinical studies were identified that compared sonographic assessment of IVC diameter with CVP and RAP and met all inclusion criteria. Despite substantial heterogeneity in measurement techniques and patient populations, most studies demonstrated moderate strength correlations between measurements of IVC diameter and collapsibility and CVP or RAP, but more favorable diagnostic accuracy using pre-specified cut points. Findings were inconsistent among mechanically ventilated patients, except in the absence of positive end-expiratory pressure.ConclusionSonographic measurement of IVC diameter and collapsibility is a valid method of estimating CVP and RAP. Given the ease, safety, and availability of this non-invasive technique, broader adoption and application of this method in clinical settings is warranted.

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Section: Discussionmentioning

confidence: 99%

The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure

Ciozda

Kedan

Kehl³

et al. 2015

Cardiovasc Ultrasound

139

116

View full text Add to dashboard Cite

show abstract

“…61, 62 the accuracy of echocardiographic RAP in AHF was questioned in a study of 71 patients using 3 different echocardiographic methods. 63 In that study, invasive and echocardiographic RAP estimates had wide limits of agreement. Therefore, assessment of LV filling pressures and RAP in practice is qualitative most of the time.…”

Section: Challenges Of Echocardiography In Ahfmentioning

confidence: 96%

Echocardiography in Acute Heart Failure: Current Perspectives

Papadimitriou

Georgiopoulou

Kort

et al. 2016

Journal of Cardiac Failure

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“…Inferior vena cava diameter and respiratory variation can be used to estimate right atrial pressure, being similarly altered in heart failure with reduced or preserved ejection fraction ( Table ). In patients with advanced heart failure, echocardiographic right atrial pressure prediction methods showed modest precision; a single IVC diameter measurement was non‐inferior to complex prediction methods . Nagueh et al .…”

Section: Imagingmentioning

confidence: 99%

Comprehensive in‐hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Harjola

Parissis

Rocca

et al. 2018

European J of Heart Fail

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This paper provides a practical clinical application of guideline recommendations relating to the inpatient monitoring of patients with acute heart failure, through the evaluation of various clinical, biomarker, imaging, invasive and non-invasive approaches. Comprehensive inpatient monitoring is crucial to the optimal management of acute heart failure patients. The European Society of Cardiology heart failure guidelines provide recommendations for the inpatient monitoring of acute heart failure, but the level of evidence underpinning most recommendations is limited. Many tools are available for the in-hospital monitoring of patients with acute heart failure, and each plays a role at various points throughout the patient's treatment course, including the emergency department, intensive care or coronary care unit, and the general ward. Clinical judgment is the preeminent factor guiding application of inpatient monitoring tools, as the various techniques have different patient population targets. When applied appropriately, these techniques enable decision making. However, there is limited evidence demonstrating that implementation of these tools improves patient outcome. Research priorities are identified to address these gaps in evidence. Future research initiatives should aim to identify the optimal in-hospital monitoring strategies that decrease morbidity and prolong survival in patients with acute heart failure.

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Precision of Echocardiographic Estimates of Right Atrial Pressure in Patients with Acute Decompensated Heart Failure

Cited by 37 publications

References 25 publications

The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure

The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure

Echocardiography in Acute Heart Failure: Current Perspectives

Comprehensive in‐hospital monitoring in acute heart failure: applications for clinical practice and future directions for research. A statement from the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

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