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. 2023 Feb;16(1):141-151.
doi: 10.1007/s12265-022-10276-3. Epub 2022 May 23.

Diagnostic Performance of Pulsed Doppler Ultrasound of the Common Femoral Vein to Detect Elevated Right Atrial Pressure in Pulmonary Hypertension

Magali Croquette  1 , Matthieu Puyade  2 , David Montani  3   4   5 , Etienne-Marie Jutant  6   7 , Marion De Géa  8 , Damien Lanéelle  9   10 , Cécile Thollot  1 , Jean-Eudes Trihan  11
Affiliations

Diagnostic Performance of Pulsed Doppler Ultrasound of the Common Femoral Vein to Detect Elevated Right Atrial Pressure in Pulmonary Hypertension

Magali Croquette et al. J Cardiovasc Transl Res. 2023 Feb.

Abstract

Right atrial pressure (RAP) is an important prognostic criterion in pulmonary hypertension (PH). The main goals were to evaluate the following: (i) the accuracy of Doppler assessment of common femoral vein flow waveform to detect elevated RAP and (ii) the diagnostic accuracy of RAP assessed by echocardiography (eRAP). Fifty-seven patients, addressed for right heart catheterization, were included in a retrospective cross-sectional study during a 6-month period. Forty-five patients (78.9%) had PH confirmed by RHC. Elevated RAP was defined by RAP ≥ 10 mmHg. Femoral venous stasis index (FVSI) was highly correlated to RAP on both univariate (p < 0.001) and multivariate analysis (p = 0.003), and showed good diagnostic performances to detect elevated RAP (specificity: 92.3% [80.0-99.3], diagnosis accuracy: 90.4 [77.4-97.3], positive likelihood ratio: 12.5 [3.01-51.97]). Diagnosis accuracy of eRAP was only 51.2% (36.2-66.1). FVSI is independently correlated to RAP and a useful tool to predict elevated RAP in PH patients.

Keywords: Doppler ultrasound; Femoral vein; Femoral venous stasis index; Pulmonary hypertension; Right atrial pressure; Right heart catheterization.

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