The utility of inferior vena cava diameter and the degree of inspiratory collapse in patients with systolic heart failure

Beşli, Feyzullah; Keçebaş, Mesut; Caliskan, Serhat; Dereli, Seçkin; Baran, İbrahim; Türker, Yasin

doi:10.1016/j.ajem.2015.02.006

Cited by 25 publications

(26 citation statements)

References 24 publications

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“…Prior studies also found high specificity for the HJR (~96%) in diagnosing HF [15, 16]. In addition to confirming these prior findings, we have also found that a positive HJR on discharge was determined by higher RAP, PASP, and PADP and was associated with a higher IVC diameter which is an accurate determinant of patients' volume status with ability to predict decompensated HF [17]. While studies showed that HJR correlated best with left-sided HF [15] and others showed stronger association with right-sided pressures [11], we found a significant relationship between a positive HJR and RAP, PCWP, PASP, and PADP, suggesting that it is a marker of elevated left-sided or right-sided filling pressures.…”

Section: Discussionsupporting

confidence: 87%

Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial

Omar

Guglin

2017

BioMed Research International

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Background. There has been a decline in emphasis of the value of physical examination in heart failure (HF) with increased reliance on cardiac imaging. We aim to study the clinical and prognostic significance of positive hepatojugular reflux (HJR) on discharge in patients hospitalized with HF. Methods. Using the ESCAPE trial data, patients were compared according to the presence or absence of a positive HJR on discharge. The primary study endpoints were all-cause mortality and a composite endpoint of death, rehospitalization, and cardiac transplant during the first 6 months after discharge. Results. Among 392 patients (age: 56 years, 74% men), the HJR correlated well with clinical and objective hemodynamic markers of volume overload including right atrial pressure (RAP, P = 0.002), pulmonary capillary wedge pressure (PCWP, P = 0.006), and inferior vena cava size during inspiration (P = 0.005) and expiration (P = 0.003). The RAP had the highest AUC for predicting a positive HJR on admission (AUC: 0.655, P = 0.004) and discharge (AUC: 0.672, P = 0.001). Cox's proportional hazards analysis revealed that a positive HJR on discharge is an independent predictor of 6-month mortality (estimated hazard ratio: 1.689; 95% CI: 1.032–2.764; P = 0.037) after adjusting for age, baseline creatinine, baseline hematocrit, baseline NYHA class, chronic obstructive pulmonary disease, and the presence of tricuspid regurgitation. Conclusion. The HJR should be routinely checked in patients admitted with acute HF throughout hospitalization and especially on discharge as it serves as an important prognostic marker for postdischarge outcomes.

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Section: Discussionsupporting

confidence: 87%

Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial

Omar

Guglin

2017

BioMed Research International

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“…Like elevated JVP, a congested IVC is also indicative of elevated right atrial pressure, as the IVC is the counterpart of the superior vena cava and it has functions that are equivalent to those of the superior vena cava …”

Section: Discussionmentioning

confidence: 98%

Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease

Kim

et al. 2016

Echocardiography

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“…The mean inferior vena cava dimensions are significantly higher in patients with decompensated congestive heart failure. 4 In addition, the collapsibility index correlates with the NT-pro BNP level. Guiotto reported that IVC collapsibility could help guide fluid removal by slow continuous ultrafiltration patients with decompensated congestive heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…The measurement of inferior vena cava (IVC) dimensions and collapsibility has been used in evaluation of patients with trauma, sepsis, and heart failure; these measurements are made easily at the bedside and do not have the risk of invasive procedures. [2][3][4] We measured inferior vena cava diameters and collapsibility in patients admitted to our medical intensive care unit with laboratory evidence of presumed acute kidney injury. The goal was to determine IVC dimensions in this group of patients and the association between changes in these dimensions and creatinine following fluid administration.…”

Section: Introductionmentioning

confidence: 99%

Inferior vena cava dimensions in patients with acute kidney injury

2016

SWRCCC

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The utility of inferior vena cava diameter and the degree of inspiratory collapse in patients with systolic heart failure

Cited by 25 publications

References 24 publications

Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial

Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial

Inferior vena cava collapsibility index, renal dysfunction, and adverse outcomes in patients with broad spectrum cardiovascular disease

Inferior vena cava dimensions in patients with acute kidney injury

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