Heart failure & cardiomyopathies
Estimation of Right Atrial Pressure by Ultrasound-Assessed Jugular Vein Distensibility in Patients With Heart Failure
Authors' conclusion
Ultrasound-assessed JV distensibility identifies patients with chronic advanced heart failure with normal RAP and better outcomes.
Study context
- Population
- Consecutive patients with chronic HFrEF undergoing pulmonary artery catheterization for advanced HF therapies workup
- Participants
- 100 vs 101
- Comparison
- Ultrasound-assessed jugular vein (JV) distensibility vs pulmonary artery catheterization RAP
- Calibrationn = 100
- Validationn = 101
- Outcome
- Identification of normal RAP (≤7 mm Hg) by JV distensibility (Valsalva-to-rest ratio of vein diameter)
Methodological detailscalibration and validation cohorts, consecutive patients
- Calibration and validation cohorts
- Consecutive patients
Performance
As reported in the abstract
Identification of normal RAP (≤7 mm Hg)
| Test or model | AUC, calibration cohort (threshold 1.6) | AUC, validation cohort | PPV of ratio >1.6, calibration cohort | PPV of ratio >1.6, validation cohort |
|---|---|---|---|---|
| JV distensibility | 0.74 (95% CI, 0.64-0.84) | 0.82 (95% CI, 0.73-0.92) | 0.86 | 0.94 |
JV distensibility
AUC, calibration cohort (threshold 1.6)0.74 (95% CI, 0.64-0.84)
AUC, validation cohort0.82 (95% CI, 0.73-0.92)
PPV of ratio >1.6, calibration cohort0.86
PPV of ratio >1.6, validation cohort0.94
Further findings
| Outcome | Low ratio (≤1.6) | High ratio (>1.6) | P value |
|---|---|---|---|
| Death, LV assist device implant or heart transplantation, by JV distensibility ratio (calibration cohort) · 2 yearsEvent rate at 2 years | 42.7% · n = 58 | 18.2% · n = 42 | log-rank P=0.034 |
| Median RAP | 8 mm Hg | 4 mm Hg | |
| PCWP | 22 mm Hg | 11 mm Hg |
- Death, LV assist device implant or heart transplantation, by JV distensibility ratio (calibration cohort): RAP and PCWP differences P<0.0001 for both
Original publication
Estimation of Right Atrial Pressure by Ultrasound-Assessed Jugular Vein Distensibility in Patients With Heart Failure. Circ Heart Fail. Published 1 February 2024. doi:10.
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