Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Mar 15;103(6):839-44.
doi: 10.1016/j.amjcard.2008.11.045.

A propensity-matched study of elevated jugular venous pressure and outcomes in chronic heart failure

Philippe Meyer  1 , O James Ekundayo, Chris Adamopoulos, Marjan Mujib, Inmaculada Aban, Michel White, Wilbert S Aronow, Ali Ahmed
Affiliations

A propensity-matched study of elevated jugular venous pressure and outcomes in chronic heart failure

Philippe Meyer et al. Am J Cardiol. .

Abstract

The independence of association between elevated jugular venous pressure (JVP) and outcomes in heart failure (HF) has not been well studied. The objective of propensity-matched study was to determine if an elevated JVP had intrinsic associations with outcomes in chronic systolic and diastolic HF. Of the 7,788 participants in the Digitalis Investigation Group trial, 1,020 (13%) had elevated JVP at baseline. Propensity scores for elevated JVP were estimated for all patients based on 32 baseline characteristics and were used to match 827 pairs of patients with normal and elevated JVP. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated to compare outcomes associated with elevated versus normal JVP during 34 months of median follow-up. Before matching, all-cause mortality occurred in 31% and 47% (unadjusted HR 1.70, 95% CI 1.54 to 1.88, p <0.0001), and all-cause hospitalization occurred in 60% and 71% (unadjusted HR 1.35, 95% CI 1.25 to 1.47, p <0.0001) of patients with normal and elevated JVP, respectively. After matching, all-cause mortality occurred in 48% and 45% (matched HR 0.95, 95% CI 0.80 to 1.12, p = 0.521), and all-cause hospitalization occurred in 70% and 70% (matched HR 0.97, 95% CI 0.87 to 1.09, p = 0.613) of patients with normal and elevated JVP, respectively. Elevated JVP had no intrinsic associations with cardiovascular mortality (matched HR 0.93, 95% CI 0.77 to 1.12, p = 0.440) or hospitalization for HF (matched HR 0.94, 95% CI 0.78 to 1.14, p = 0.532). In conclusion, an elevated JVP is a marker of higher burden of sickness and poor outcomes. However, elevated JVP had no intrinsic association with mortality or hospitalization in chronic HF.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
Love plot displaying absolute standardized differences for covariates between chronic heart failure patients with and without elevated jugular venous pressure, before and after propensity score matching (ACE=angiotensin-converting enzyme; NYHA=New York Heart Association)
Figure 2
Figure 2
Kaplan-Meier plots for (a) all-cause mortality, and (b) all-cause hospitalization (CI=confidence interval; HR=hazard ratio; JVP=jugular venous pressure)
Figure 3
Figure 3
Association of elevated jugular venous pressure (JVP) with all-cause mortality in subgroups of propensity-matched chronic heart failure patients (ACE=angiotensin-converting enzyme; CI=confidence interval; HR=hazard ratio)
See this image and copyright information in PMC

References

    1. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC, Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2005;112:e154–235. - PubMed
    1. Drazner MH, Rame JE, Stevenson LW, Dries DL. Prognostic importance of elevated jugular venous pressure and a third heart sound in patients with heart failure. N Engl J Med. 2001;345:574–581. - PubMed
    1. Rosenbaum PR, Rubin DB. The central role of propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.
    1. Rubin DB. Estimating causal effects from large data sets using propensity scores. Ann Intern Med. 1997;127:757–763. - PubMed
    1. Rubin DB. Using propensity score to help design observational studies: Application to the tobacco litigation. Health Services and Outcomes Research Methodology. 2001;2:169–188.

Publication types