Sensitivity and reproducibility of inferior vena cava diameter and superior vena cava flow velocity measurements to changes in cardiac preload in subjects with hypertension

TY - JOUR

T1 - Sensitivity and reproducibility of inferior vena cava diameter and superior vena cava flow velocity measurements to changes in cardiac preload in subjects with hypertension

AU - Mcnally, Ryan John

AU - Farukh, Bushra

AU - Chowienczyk, Phil J

AU - Faconti, Luca

N1 - Funding Information: This work was performed as part of the AIM HY (Ancestry and biological Informative Markers in stratification of Hypertension) stratified medicines program in hypertension funded by the Medical Research Council and The British Heart Foundation (MR/M016560/1). We also acknowledge support from the Department of Health via a National Institute for Health Research (NIHR) Biomedical Research Centre and Clinical Research Facility award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London, and the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. Publisher Copyright: © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

PY - 2022/1/1

Y1 - 2022/1/1

N2 - OBJECTIVES: We investigated the sensitivity and reproducibility of inferior vena cava (IVC) diameters and superior vena cava (SVC) flow velocities in detecting changes in cardiac preload in clinically euvolemic subjects with hypertension.METHODS: Measurements were obtained during passive leg raising (PLR) and lower limb venous occlusion (LVO), interventions which respectively transiently increase and decrease cardiac preload. Measurements were made in 36 subjects and repeated on two separate occasions to examine reproducibility.RESULTS: During PLR, there was no significant change in IVC diameters, but peak flow velocity of the SVC S wave increased by 6.5 (95% confidence interval 1.6-11.3) cm/s ( P = 0.01). During LVO, IVC diameter in expiration decreased by 3.2 (1.7-4.7) mm and the SVC S wave decreased by 9.7 (4.4-14.7) cm/s ( P < 0.001). Venae cavae-derived indices can be used to assess changes in preload within the physiological range in euvolemia. CONCLUSIONS: Despite suboptimal reproducibility of baseline measurements, high agreeability between the changes in IVC diameter and SVC flow after LVO suggests that these indices can be used to monitor changes in cardiac preload.

AB - OBJECTIVES: We investigated the sensitivity and reproducibility of inferior vena cava (IVC) diameters and superior vena cava (SVC) flow velocities in detecting changes in cardiac preload in clinically euvolemic subjects with hypertension.METHODS: Measurements were obtained during passive leg raising (PLR) and lower limb venous occlusion (LVO), interventions which respectively transiently increase and decrease cardiac preload. Measurements were made in 36 subjects and repeated on two separate occasions to examine reproducibility.RESULTS: During PLR, there was no significant change in IVC diameters, but peak flow velocity of the SVC S wave increased by 6.5 (95% confidence interval 1.6-11.3) cm/s ( P = 0.01). During LVO, IVC diameter in expiration decreased by 3.2 (1.7-4.7) mm and the SVC S wave decreased by 9.7 (4.4-14.7) cm/s ( P < 0.001). Venae cavae-derived indices can be used to assess changes in preload within the physiological range in euvolemia. CONCLUSIONS: Despite suboptimal reproducibility of baseline measurements, high agreeability between the changes in IVC diameter and SVC flow after LVO suggests that these indices can be used to monitor changes in cardiac preload.

KW - Hypertension

KW - inferior vena cava

KW - preload

KW - superior vena cava

UR - http://www.scopus.com/inward/record.url?scp=85129317076&partnerID=8YFLogxK

U2 - 10.4103/jcecho.jcecho_56_21

DO - 10.4103/jcecho.jcecho_56_21

M3 - Article

C2 - 35669130

AN - SCOPUS:85129317076

SN - 2211-4122

VL - 32

SP - 6

EP - 11

JO - Journal of Cardiovascular Echography

JF - Journal of Cardiovascular Echography

IS - 1

ER -