Role of the femoral vein doppler in acute heart failure patients: results from a prospective multicentric study

Torres-Arrese, Marta; Mata-Martínez, Arantzazu; Luordo, Davide; Casasola-Sánchez, Gonzalo García; Montero-Hernández, Esther; Cobo‐Marcos, Marta; Tejeda-Jurado, Fabián; Berrocal-Espinosa, Paula; Martínez-Ballester, Juan Francisco; Tung‐Chen, Yale

doi:10.1016/j.rceng.2023.04.004

Cited by 1 publication

(1 citation statement)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the authors, they valued: pulsatility, retrograde flow (with different speeds as cutoff points), respiratory phasicity, the pulsatility index, maximum or minimum speeds, or cardiac modulation. To choose the most optimal parameter, we took into account the interesting findings of Taute et al, who assessed the presence of cardiac modulation (which is equivalent to the cardiac pattern or pulsatility without respiratory phasicity) in 47 patients with acute pulmonary embolism, and observed that all patients with a right cardiac score of ≥1.75 had cardiac modulation (Sn 96%, Sp 88%) [8]; and our own preliminary findings; in which we observed that the pulsatile pattern in the PW-Doppler in the CFV reasonably detected elevated PHP (AUC 0.8, Sn 95%, Sp 64%, PPV 84%, NPV 84%) in 74 patients with heart failure [9]. In our previous study, we studied the role of pulsatility, retrograde flow (which may be present if the patient has venous insufficiency), and respiratory phasicity to establish which were the best variables.…”

Section: Discussionsupporting

confidence: 65%

The Cardiac Pulsed Wave Doppler Pattern of the Common Femoral Vein in the Diagnosis of the Likelihood of Severe Pulmonary Hypertension: Results from a Prospective, Multicen-Tric Study

Torres Arrese,

Barberá Rausell,

Li-Zhu

et al. 2024

Preprint

View full text Add to dashboard Cite

Background and Objectives: Pulmonary Hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the Probability of Pulmonary Hypertension (PHP) using advanced echocardiography, before pro-ceeding to right heart catheterization. This study proposes using the common femoral vein (CFV), an accessible vein that reflects right atrial pressure, as an alternative method to assess the like-lihood of severe PHP. Materials and Methods: This prospective observational study included 175 emergency patients from three hospitals. Ultrasound assessed the Pulsed Wave Doppler (PW-Doppler) morphology of the CFV. This diagnostic yield for high PHP was evaluated along-side traditional ultrasound parameters (right-to-left ventricular basal diameter ratio greater than 1 (RV>LV), septal flattening, right ventricular outflow acceleration time of less than 105 ms and/or mesosystolic notching, pulmonary artery diameter greater than the aortic root diameter or over 25 mm, early pulmonary regurgitation maximum velocity >2.2 m/s, TAPSE/PASP less than 0.55, in-ferior vena cava (IVC) diameter over 21 mm with decreased inspiratory collapse, and right atrial (RA) area over 18 cm²). Results: The CFV's PW-Doppler cardiac pattern correlated strongly with high PHP, showing a sensitivity (Sn) of 72% and a specificity (Sp) of 96%. RA dilation and TAPSE/PASP < 0.55 also played significant diagnostic roles. Conclusions: The CFV's PW-Doppler cardiac pattern is an effective indicator of high PHP, allowing reliable exclusion of this condition when absent. This approach could simplify initial PHP evaluation in emergency settings or where echocardiographic resources are limited.

show abstract

Section: Discussionsupporting

confidence: 65%