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Comparative Study
. 2018 Apr;41(4):510-517.
doi: 10.1002/clc.22915. Epub 2018 Apr 17.

Usefulness of inferior vena cava ultrasonography in outpatients with chronic heart failure

Jose Curbelo  1   2 , Maria Aguilera  1   2 , Pablo Rodriguez-Cortes  1   2 , Paloma Gil-Martinez  1   2 , Carmen Suarez Fernandez  1   2
Affiliations
Comparative Study

Usefulness of inferior vena cava ultrasonography in outpatients with chronic heart failure

Jose Curbelo et al. Clin Cardiol. 2018 Apr.

Abstract

Background: Inferior vena cava (IVC) ultrasonography has been used for the diagnosis and prognosis of acute heart failure (HF). Its usefulness in chronic HF is less known.

Hypothesis: IVC ultrasonography is a useful tool in the care of patients with chronic HF.

Methods: For this prospective cohort study, 95 patients with chronic HF were included consecutively as they attended scheduled medical visits. Ultrasound was done with a 5-MHz convex probe device, calculating IVC collapse index (IVCCI). Follow-up time was 1 year. Outcome events were worsening HF, hospital admission for HF, HF mortality, and all-cause mortality.

Results: Worsening HF occurred in 70.9% of patients with IVCCI <30% and 39.1% of patients with IVCCI >50%, with a hazard ratio (HR) of 2.8 (95% CI: 1.3-6.2) adjusted by multivariable analysis. Regarding hospitalization, 45.3% of patients with IVCCI <30% required admission, compared with 5.9% of patients with IVCCI >50%; the adjusted HR was 13.9 (95% CI: 1.7-113.0). Mortality was higher in the IVCCI <30% group, with 25.7% all-cause mortality and 18.6% HF mortality, whereas in the IVCCI >50% group these values were 13% and 4.7%, respectively. However, these differences did not reach statistical significance. ROC analysis was performed and the AUC for IVCCI was not higher than that for NTproBNP for any of the outcomes studied.

Conclusions: IVC ultrasonography is a useful tool in follow-up of patients with chronic HF, allowing identification of patients at high risk of worsening and hospitalization. However, its usefulness is not higher than that of NTproBNP.

Keywords: Chronic Heart Failure; Inferior Vena Cava; POCUS; Ultrasonography.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1
Figure 1
Correlation between IVCCI and LVEF and eGFR. Abbreviations: eGFR, estimated glomerular filtrate rate; IVCCI, inferior vena cava collapse index; LVEF, left ventricular ejection fraction
Figure 2
Figure 2
Kaplan–Meier curve analysis of IVCCI, for worsening HF, HF hospitalization, all‐cause mortality, and HF mortality at 1‐year follow‐up. Abbreviations: HF, heart failure; IVCCI, inferior vena cava collapse index
Figure 3
Figure 3
Comparison of prognostic capacity of IVC parameters and NTproBNP by AUCs for each outcome variable. Abbreviations: AUC, area under the curve; IVC, inferior vena cava; IVCCI, inferior vena cava collapse index; NTproBNP, N‐terminal pro‐B‐type natriuretic peptide
See this image and copyright information in PMC

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