TY - JOUR
T1 - Impact of Body Size on Inferior Vena Cava Parameters for Estimating Right Atrial Pressure
T2 - A Need for Standardization?
AU - Taniguchi, Tatsunori
AU - Ohtani, Tomohito
AU - Nakatani, Satoshi
AU - Hayashi, Kenichi
AU - Yamaguchi, Osamu
AU - Komuro, Issei
AU - Sakata, Yasushi
N1 - Funding Information:
This study was supported in part by grants from the Japanese Society for the Promotion of Science (No. 15K09080 ).
Publisher Copyright:
© 2015 American Society of Echocardiography.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background Inferior vena cava (IVC) diameter and its respiratory change, as determined using echocardiography, are commonly used to assess right atrial pressure (RAP). Despite the widespread use of the IVC approach for RAP assessment, the relations among body surface area (BSA), IVC diameter, and respirophasic change remain unclear. The aim of this study was to investigate the impact of BSA on IVC parameters for predicting elevated RAP. Methods Ninety consecutive patients undergoing right-heart catheterization or central venous catheter insertion were prospectively included. To investigate the impact of BSA on IVC parameters, patients were divided into higher and lower BSA groups by comparing individual BSA measurements with the median value. Optimal cutoff points of IVC parameters for detecting RAP of ≥10 mm Hg were defined using receiver operating characteristic curves. Results The median RAP and BSA were 8 mm Hg (range, 1-25 mm Hg) and 1.61 m2 (range, 1.23-2.22 m2), respectively. In all patients, the optimal cutoff point for maximal IVC diameter (IVCDmax) and IVC collapsibility for the detection of RAP ≥ 10 mm Hg were 20 mm and 49.0%, respectively. The optimal cutoff point of IVCDmax for predicting RAP of ≥10 mm Hg was significantly larger in patients with higher BSAs than in those with lower BSAs (21 vs 17 mm, P =.0342). No differences in collapsibility indices were detected between the two groups. IVCDmax was larger in men (19 ± 5 vs 17 ± 5 mm in women, P =.0347) and weakly correlated with BSA (r = 0.35, P =.0007), whereas no relation was found between IVCDmax and age. However, the partial correlation coefficient of the entire cohort demonstrated that only BSA was still associated with IVCDmax after adjusting for age and gender (partial correlation coefficient = 0.32, P =.0020). Conclusions Body size, measured as BSA, is important to consider when IVC diameter is used to assess RAP. The optimal cutoff point of IVCDmax was 21 mm for patients with larger BSAs and 17 mm for those with smaller BSAs. However, the cutoff point of IVC collapsibility was not influenced by the difference of BSA.
AB - Background Inferior vena cava (IVC) diameter and its respiratory change, as determined using echocardiography, are commonly used to assess right atrial pressure (RAP). Despite the widespread use of the IVC approach for RAP assessment, the relations among body surface area (BSA), IVC diameter, and respirophasic change remain unclear. The aim of this study was to investigate the impact of BSA on IVC parameters for predicting elevated RAP. Methods Ninety consecutive patients undergoing right-heart catheterization or central venous catheter insertion were prospectively included. To investigate the impact of BSA on IVC parameters, patients were divided into higher and lower BSA groups by comparing individual BSA measurements with the median value. Optimal cutoff points of IVC parameters for detecting RAP of ≥10 mm Hg were defined using receiver operating characteristic curves. Results The median RAP and BSA were 8 mm Hg (range, 1-25 mm Hg) and 1.61 m2 (range, 1.23-2.22 m2), respectively. In all patients, the optimal cutoff point for maximal IVC diameter (IVCDmax) and IVC collapsibility for the detection of RAP ≥ 10 mm Hg were 20 mm and 49.0%, respectively. The optimal cutoff point of IVCDmax for predicting RAP of ≥10 mm Hg was significantly larger in patients with higher BSAs than in those with lower BSAs (21 vs 17 mm, P =.0342). No differences in collapsibility indices were detected between the two groups. IVCDmax was larger in men (19 ± 5 vs 17 ± 5 mm in women, P =.0347) and weakly correlated with BSA (r = 0.35, P =.0007), whereas no relation was found between IVCDmax and age. However, the partial correlation coefficient of the entire cohort demonstrated that only BSA was still associated with IVCDmax after adjusting for age and gender (partial correlation coefficient = 0.32, P =.0020). Conclusions Body size, measured as BSA, is important to consider when IVC diameter is used to assess RAP. The optimal cutoff point of IVCDmax was 21 mm for patients with larger BSAs and 17 mm for those with smaller BSAs. However, the cutoff point of IVC collapsibility was not influenced by the difference of BSA.
KW - Body surface area
KW - Inferior vena cava
KW - Right atrial pressure
KW - Two-dimensional imaging
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U2 - 10.1016/j.echo.2015.07.008
DO - 10.1016/j.echo.2015.07.008
M3 - Article
C2 - 26272698
AN - SCOPUS:84949625871
SN - 0894-7317
VL - 28
SP - 1420
EP - 1427
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 12
ER -