Evaluation of size and dynamics of the inferior vena cava as an index of right-sided cardiac function

Moreno, Fidela; Hagan, Arthur D.; Holmén, John; Pryor, T. Allan; Strickland, Richard D.; Castle, C. Hilmon

doi:10.1016/0002-9149(84)90034-1

Cited by 291 publications

(181 citation statements)

References 16 publications

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“…The rate of high-quality image acquisition (89%) was somewhat lower than previously reported (94 to 95%), but the previous studies used experienced sonographers on full echocardiographic platforms (20,32). A feasibility rate of nearly 90% given the more limited expertise and equipment used in our study is excellent and similar to previous results using an HCU in the hands of noncardiologists (28).…”

Section: Discussionsupporting

confidence: 75%

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Brennan

Ronan

Goonewardena

et al. 2006

Clinical Journal of the American Society of Nephrology

189

133

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Accurate intravascular volume assessment is critical in the treatment of patients who receive chronic hemodialysis (HD) therapy. Clinically assessed dry weight is a poor surrogate of intravascular volume; however, ultrasound assessment of the inferior vena cava (IVC) is an effective tool for volume management. This study sought to determine the feasibility of using operators with limited ultrasound experience to assess IVC dimensions using hand-carried ultrasounds (HCU) in the outpatient clinical setting. The IVC was assessed in 89 consecutive patients at two outpatient clinics before and after HD. Intradialytic IVC was recorded during episodes of hypotension, chest pain, or cramping. High-quality IVC images were obtained in 79 of 89 patients. Despite that 89% of patients presented at or above dry weight, 39% of these patients were hypovolemic by HCU. Of the 75% of patients who left HD at or below goal weight, 10% were still hypervolemic by HCU standards. Hypovolemic patients had more episodes of chest pain and cramping (33 versus 14%, P ‫؍‬ 0.06) and more episodes of hypotension (22 versus 3%, P ‫؍‬ 0.02). The clinic with a higher prevalence of predialysis hypovolemia had significantly more intradialytic adverse events (58 versus 27%; P ‫؍‬ 0.01). HCU measurement of the IVC is a feasible option for rapid assessment of intravascular volume status in an outpatient dialysis setting by operators with limited formal training in echocardiography. There is a poor relationship between dry weight goals and IVC collapsibility. Practice variation in the maintenance of volume status is correlated with significant differences in intradialysis adverse events.

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Section: Discussionsupporting

confidence: 75%

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Brennan

Ronan

Goonewardena

et al. 2006

Clinical Journal of the American Society of Nephrology

189

133

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“…Therefore, small, collapsible IVCs as visualized by echocardiography represent low right atrial pressures, whereas large, non-collapsible IVCs reflect high right atrial pressures. In the presence of marked volume overload, the respiratory cycle leads to minimal change in diameter of IVC, regardless of its absolute diameter (26). This depends on the peculiar non-linear pressure-diameter relationship of the IVC so that, above a threshold pressure (i.e., CVP >20 mmHg), no further increase in IVC diameter can be observed (27,28).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound evaluation of the inferior vena cava collapsibility index in congestive heart failure patients treated with intravenous diuretics: new insights about its relationship with renal function: An observational study

Vecchis¹,

Ariano²,

Fusco³

et al. 2012

Anadolu Kardiyol Derg

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Ultrasound evaluation of the inferior vena cava collapsibility index in congestive heart failure patients treated with intravenous diuretics: new insights about its relationship with renal function: An observational study ABSTRACTObjective: In chronic heart failure (CHF), collapsibility index of the inferior vena cava (IVCCI) is used for noninvasive ultrasonographic appraisal of central venous pressure, but it also may be related both to estimated glomerular filtration rate (eGFR) and renal outcome. Methods: On the basis of retrospective observational cohort study, we analyzed 49 patients with right or biventricular CHF in III NYHA class, who had undergone intravenous intensive treatment with furosemide. Aggravated renal dysfunction (ARD) was defined by serum creatinine (Cr) increase of ≥0.3 mg/dL from baseline. IVCCI was categorized in three layers (IVCCI ≤15%, IVCCI 16-40% and IVCCI >40%). The predictors of ARD were searched for as well as any relation between basal IVCCI and both eGFR at admission and occurrence of ARD. Results: Overall, 15 cases and 34 controls were compared. Multivariate predictors of ARD were a lower basal eGFR (HR: 0.82 CI: 0.72-0.94 p=0.0045) and intravenous furosemide daily mean dose >80 mg (HR: 48.62 CI: 1.62-3841.5 p=0.0430). A very significant positive correlation was found between IVCCI at admission ≤ 15% and basal eGFR (r=0.96 p<0.0001), while a negative correlation with eGFR was detected in the IVCCI highest (>40%) range (r=-0.696 p=0.0013). Furthermore, the category with basal IVCCI >40% showed a higher rate of ARD compared to that with basal IVCCI 16-40% (p<0.05). Conclusion:On the basis of the demonstrated u-shaped relationship between IVCCI and eGFR both the stratum with the highest (>40%) and the one with the lowest (≤15%) basal IVCCI may be associated with increased risk of ARD. (Anadolu Kardiyol Derg 2012; 12: 391-400) Key words: Heart failure, ultrasound monitoring, inferior vena cava, diuretics, acute kidney injury, regression analysis

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“…Az IVC átmérőjét a ráhelyezett M-mód segít-ségével a JP-be szájadzástól körülbelül 0,5-3 cm-re a hepaticus vénák beszájadzásától proximálisan a kilégzés végén mérjük [3,5]. Az IVC kollapszusát szippantásra és nyugodt belégzésre létrejövő IVC-átmérő-változásként értékeljük.…”

Section: *Az Inferior Vena Cava Vizsgálataunclassified

“…A JP hossztengelyé-nek felénél mérjük annak keresztátmérőjét a JP-i szabad (anterolateralis) fal és az interatrialis septum között arra merőleges irányban (normálérték <44 mm) [3,5,6] (1. ábra). A legújabb guideline szerint az L értéke férfiak-ban 2,4 ± 0,3 cm/m 2 , míg nőkben 2,5 ± 0,3 cm/m 2 , ugyanezen értékek a keresztátmérőre vonatkoztatva 1,9 ± 0,3 cm/m 2 nemtől függetlenül [7].…”

Section: *A Jobb Pitvari áTmérők Méréseunclassified

A jobb pitvar echokardiográfiás vizsgálata – az M-módtól a 3D speckle-tracking képalkotásig

Nemes

Forster

2016

Orvosi Hetilap

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A jobb pitvar echokardiográfiás vizsgálata a jelen gyakorlatban nagy kihívás és csak korlátozott lehetőségek állnak rendelkezésünkre. Az utóbbi évtizedekben végbement technikai fejlesztések lehetővé teszik a komplex jobb pitvari szívciklusos mozgások volumetrikus és funkcionális analízisét. Ennek az összefoglaló közleménynek a célja a jelenleg elérhető rutineljárások mellett a legkorszerűbbnek tekinthető háromdimenziós és/vagy speckle-tracking echokardiográfiás módszerek bemutatása a jobb pitvar vizsgálatában. Orv. Hetil., 2016, 157(43), 1698-1707. ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések 2D = kétdimenziós; 2DE = kétdimenziós echokardiográfia; 2DSTE = kétdimenziós speckle-tracking echokardiográfia; 3D = háromdimenziós; 3DSTE = háromdimenziós speckle-tracking echokardiográfia; A = kései, a pitvari kontrakció idejére eső (A-hullám) JK-i diasztolés telődés sebessége (DE-vel mérve); A 1 = JP-i area; A' = tricuspidalis anulus előmozdulásának longitudinális sebessége késő diasztoléban (TDI-vel mérve); AP4CH = (apical 4-chamber view) apicalis 4 üregi nézet; BK = bal kamra; BP = bal pitvar; DE = Doppler-echokardiográfia; E = korai gyors JK-i diasztolés telődés sebessége (DE-vel mér-ve); E' = tricuspidalis anulus előmozdulásának longitudinális sebessége kora diasztoléban (TDI-vel mérve); EKG = elektrokardiográfia; IVC = inferior vena cava; JK = jobb kamra; L = JP-i hossztengelyi átmérő; MME = M-mód echokardiográfia; RAEF = (right atrial ejection force) jobb pitvari ejekciós erő; RT3DE = real-time háromdimenziós echokardiográfia; RV = (right ventricular) jobb kamrai; S' = tricuspidalis anulus elő-mozdulásának longitudinális sebessége szisztoléban (TDI-vel mérve); STE = speckle-tracking echokardiográfia; SVC = superior vena cava; TDI = (tissue Doppler imaging) szöveti Doppler-echokardiográfia; V = JP-i térfogat; Vd = a hepaticus vénában Dopplerrel mért diasztolés hullám sebessége; Vs = a hepaticus vénában Dopplerrel mért szisztolés hullám sebessége

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Evaluation of size and dynamics of the inferior vena cava as an index of right-sided cardiac function

Cited by 291 publications

References 16 publications

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Handcarried Ultrasound Measurement of the Inferior Vena Cava for Assessment of Intravascular Volume Status in the Outpatient Hemodialysis Clinic

Ultrasound evaluation of the inferior vena cava collapsibility index in congestive heart failure patients treated with intravenous diuretics: new insights about its relationship with renal function: An observational study

A jobb pitvar echokardiográfiás vizsgálata – az M-módtól a 3D speckle-tracking képalkotásig

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