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

Abstract

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

Prediction of Prognostic Hemodynamic Indices in Pulmonary Hypertension Using Non-Invasive Parameters

“…In our study the results of correlation analysis as well as ROC curve analysis (see Supplementary Tables S2 and S4) argued for choosing IVCin instead of IVCex or IVCcoll as a hemodynamic status predictor. This choice was also consistent with the results of some previous studies showing higher value of IVCin as predictor of elevated right atrial pressure [7,18,32,33].…”

Detection of Pulmonary Hypertension with Systolic Pressure Estimated by Doppler Echocardiography

“…This suggests that sPAPECHO had a detection accuracy that was the same as that of TRPG. Given the inaccuracies of RAP estimation using the ultrasound measurements of the inferior vena cava diameter together with its respiratory variation, [28][29][30] the current guideline recommends using TRPG as the main variable for assessing the echocardiographic probability of PH. 1) However, our results suggest that sPAPECHO using RAP estima-tion according to the current ASE guideline 4) might serve as an accurate screening for PH as TRPG.…”

A Two Parameters for the Evaluation of Hypovolemia in Patients with Septic Shock: Inferior Vena Cava Collapsibility Index (IVCCI), Delta Cardiac Output

“…In our study, we investigated whether the IVCCI and ΔCO values obtained by echocardiography and used for predicting fluid requirements were correlated with one another. In addition, a review of the literature found the IVCCI cutoff value in patients with septic shock was accepted as 40% in terms of response to fluid expansion [10–12]. We thus considered the IVCCI cutoff value as 40% and aimed to identify a cutoff value for ΔCO; we also examined whether 1 of these 2 parameters was, based on a clinician’s general experience, sufficient for the diagnosis of hypovolemia in patients with septic shock.…”

“…It also reflects the patient’s fluid status [18,19]. Although the literature describes cutoff values ranging from 39% to 42% for the IVCCI in terms of response to fluid expansion [7–9], the cutoff value of 40% is most commonly reported [10–12]. In our study, we considered IVCCI values of 40% or more as hypovolemia.…”

“…The IVCCI reflects the decrease in the inferior vena cava diameter during inspiration [7]. Although the literature describes cutoff values ranging from 39% to 42% for the IVCCI in terms of response to fluid expansion [7–9], the cutoff value of 40% has been most commonly reported [10–12]. IVCCI describes hypovolemia associated with low RAP [13].…”