Impact of Body Size on Inferior Vena Cava Parameters for Estimating Right Atrial Pressure: A Need for Standardization?

Taniguchi, Takao; Ohtani, Tomohito; Nakatani, Satoshi; Hayashi, Kenichi; Yamaguchi, Osamu; Komuro, Issei; Sakata, Yasushi

doi:10.1016/j.echo.2015.07.008

Cited by 45 publications

(18 citation statements)

References 20 publications

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“…Taniguchi et al reported that the cut-off points determined for respirophasic changes were not affected by body size. 19 There was also no significant difference in IVCCI between the larger and smaller BSA subgroups in the present study. These results, as well as our findings, suggest that the respiratory force during inspiration is not affected by body size; therefore, IVCCI should be similar among the various races.…”

Section: Resultsmentioning

confidence: 31%

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―

Kawata

Daimon

Lee

et al. 2017

Circ J

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Association of Echocardiography. 3,4 However, in the clinical setting, sometimes the invasive RAP and RAP estimated from IVC parameters are not concordant. As a matter of fact, despite the widespread use of the IVC approach for RAP assessment, there are no previous studies that have evaluated this technique in comparison with simultaneous invasive methods. 5-8 There is no report that has compared invasive RAP with simultaneously obtained IVC parameters in a large cohort, and only a few small studies 9-11 have been published. The numbers of subjects in those studies were merely 35, 9 71, 10 and 27. 11 Moreover, most of the previous studies that support the current guidelines are derived from US and European populations. Although the current guidelines suggest a maximal IVCD A n elevated right atrial pressure (RAP) is a major prognostic predictor of morbidity and mortality in patients with pulmonary hypertension. 1 Noninvasive assessment of RAP is used to estimate systolic pulmonary artery pressure in conjunction with the tricuspid regurgitation pressure gradient, and this assessment also plays a critical role in the management of volume control in patients with congestive heart failure. 2 Currently, estimation of RAP using ultrasound measurements of the inferior vena cava (IVC) diameter (IVCD), together with its respiratory variation, is commonly performed, because it is simple and noninvasive and recommended in the current guidelines of the American Society of Echocardiography in conjunction with the European

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Section: Resultsmentioning

confidence: 31%

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―

Kawata

Daimon

Lee

et al. 2017

Circ J

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“…There are only limited data suggesting an effect of body size on IVC diameter [19], and to support indexing IVC diameter to body surface area (BSA) for the estimation of RAP. A study from 1981 observed a weak correlation of indexed IVC diameter with RAP [20], and a more contemporary study showed no improvement in diagnostic performance of IVC measurements as an estimate of RAP with indexing to BSA [18].…”

Section: Discussionmentioning

confidence: 99%

“…A study from 1981 observed a weak correlation of indexed IVC diameter with RAP [20], and a more contemporary study showed no improvement in diagnostic performance of IVC measurements as an estimate of RAP with indexing to BSA [18]. A study from 2015 showed no improvement in diagnostic performance after indexing IVC diameter to BSA, but found a significantly lower optimal cut point for IVC diameter in the estimation of RAP among patients with small BSA [19]. Guideline recommendations currently do not recommend indexing IVC size to BSA.…”

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

155

119

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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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“…Second, we did not use a sniff maneuver when determining the relative inspiratory decrease in IVC dimensions. However, measurements during quiet respiration have been found to discriminate a normal from an elevated RA pressure with similar accuracy (Brennan et al 2007;Taniguchi et al 2015). Third, although a majority of athletes were competitive at the national level, not all could be termed top-level athletes as in previous studies (Goldhammer et al 1999;Zeppilli et al 1995).…”

Section: Limitationsmentioning

confidence: 92%

Echocardiographic Characterization of the Inferior Vena Cava in Trained and Untrained Females

Hedman

Nylander

Henriksson

et al. 2016

Ultrasound in Medicine & Biology

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The aim of the study was to explore the long- and short-axis dimensions, shape and collapsibility of the inferior vena cava in 46 trained and 48 untrained females (mean age: 21 ± 2 y). Echocardiography in the subcostal view revealed a larger expiratory long-axis diameter (mean: 24 ± 3 vs. 20 ± 3 mm, p < 0.001) and short-axis area (mean: 5.5 ± 1.5 vs. 4.7 ± 1.4 cm, p = 0.014) in trained females. IVC shape (the ratio of short-axis major to minor diameters) and the relative decrease in IVC dimension with inspiration were similar for the two groups. The IVC long-axis diameter reflected short-axis minor diameter and was correlated to maximal oxygen uptake (r = 0.52, p < 0.01). In summary, the results indicate that trained females have a larger IVC similar in shape and respiratory decrease in dimensions to that of untrained females. The long-axis diameter corresponded closely to short-axis minor diameter and, thus, underestimates maximal IVC diameter.

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Impact of Body Size on Inferior Vena Cava Parameters for Estimating Right Atrial Pressure: A Need for Standardization?

Cited by 45 publications

References 20 publications

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―

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

Echocardiographic Characterization of the Inferior Vena Cava in Trained and Untrained Females

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Impact of Body Size on Inferior Vena Cava Parameters for Estimating Right Atrial Pressure: A Need for Standardization?

Cited by 45 publications

References 20 publications

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population ― Comparative Simultaneous Ultrasound-Catheterization Study ―

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population ― Comparative Simultaneous Ultrasound-Catheterization Study ―

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

Echocardiographic Characterization of the Inferior Vena Cava in Trained and Untrained Females

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Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―

Reconsideration of Inferior Vena Cava Parameters for Estimating Right Atrial Pressure in an East Asian Population　― Comparative Simultaneous Ultrasound-Catheterization Study ―