Peripheral Venous Pressure Measurements to Evaluate Congestion in Heart Failure.
J Card Fail
; 29(9): 1319-1323, 2023 09.
Article
in En
| MEDLINE
| ID: mdl-35042656
ABSTRACT
BACKGROUND:
Accurate bedside assessment of congestion in the management of patients with heart failure remains challenging. As a continuous conduit of circulating fluid, systemic congestion represented by high right atrial pressure (RAP) may be reflected by peripheral venous pressure (PVP). We evaluated the reliability of PVP measurements for assessing congestion beyond conventional clinical assessments. METHODS ANDRESULTS:
We performed conventional congestion assessments and PVP measurements in 95 patients undergoing pulmonary artery catheterization. PVP was measured via the 22-gauge peripheral venous access placed in the upper extremity. The median RAP and PVP was 7 (interquartile range [IQR] 5-11) mmHg and 9 (IQR 7-12) mmHg, respectively, with a mean bias of 1.8 ± 2.6 mmHg. PVP exhibited a strong linear correlation with RAP (Spearman Râ¯=â¯0.81; P < 0.001). PVP demonstrated greater discriminatory power for both RAP ≤ 8 mmHg (area under the curve [AUC] 0.91 [95% confidence interval 0.85-0.97]; sensitivity 75%; specificity 87%) and RAP > 12 mmHg (AUC 0.98 [0.95-1.00]; sensitivity 88%; specificity 95%) than edema, jugular venous pressure, pulmonary congestion on chest radiograph, B-type natriuretic peptide levels, and inferior vena cava diameter.CONCLUSIONS:
PVP measured via peripheral venous access strongly correlates with invasively obtained RAP. PVP measurements may improve current bedside assessments of congestion.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heart Failure
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
J Card Fail
Journal subject:
CARDIOLOGIA
Year:
2023
Type:
Article
Affiliation country:
Japan