Usefulness of hand-carried ultrasound to predict elevated left ventricular filling pressure.


Journal Article

Detection of increased left ventricular filling pressure (LVFP) is paramount in the evaluation and treatment of patients with left heart failure, yet difficult to assess directly at the bedside. Although inferior vena cava (IVC) examination can detect increased right atrial pressure, a used surrogate for high LVFP, this assumption has not been directly tested. We evaluated whether assessment of IVC size and respirophasic variation could be used to predict increased LVFP. Seventy-two patients with chronic heart failure underwent right heart catheterization and limited echocardiographic examination focused on the IVC. IVC size and collapsibility were evaluated for their ability to predict a wedge pressure>or=15 mm Hg. In conclusion, an IVC maximum dimension of 2.0 cm and IVC collapsibility of 45% were the optimal cutoffs to predict an increased pulmonary capillary wedge pressure, with sensitivities of 75% and 83% and specificities of 83% and 71%, respectively.

Full Text

Duke Authors

Cited Authors

  • Blair, JE; Brennan, JM; Goonewardena, SN; Shah, D; Vasaiwala, S; Spencer, KT

Published Date

  • January 15, 2009

Published In

Volume / Issue

  • 103 / 2

Start / End Page

  • 246 - 247

PubMed ID

  • 19121445

Pubmed Central ID

  • 19121445

Electronic International Standard Serial Number (EISSN)

  • 1879-1913

Digital Object Identifier (DOI)

  • 10.1016/j.amjcard.2008.08.061


  • eng

Conference Location

  • United States