Relationship between Central Venous Pressure and Collapsibility Indices of Internal Jugular Veins and Inferior Vena Cava in Heart Failure Patients

Abstract

Background: Heart failure (HF) is number one reason for hospitalization in people over 65 years with nearly 1 million patients  hospitalized every year in US and Europe. 

Objectives: To study the correlation between invasive central venous pressure (CVP) and  collapsibility indices of internal jugular veins (IJVs) and inferior vena cava (IVC) utilizing ultrasonography in hospitalized HF patients.  

Methods: This prospective observational study had been conducted on 55 participants aged from >18 years old with decompensated HF  admitted to CCU of Menoufia University hospitals. Clinical evaluation was done by using EVEREST score. CVP catheter was inserted via  right (RT) subclavian vein. Ultrasound examination was performed using the GE Vivid S5 diagnostic US system. 

Results: There was  positive correlation between CVP and expiration diameter of (IVC, RT IJV and LT IJV) at admission and discharge. Negative correlation  existed between CVP and CI of (IVC, RT IJV and LT IJV) at admission and discharge. CVP, expiration, inspiration diameter of (IVC, RT IJV and  LT IJV) and EVEREST score had been significantly lower at discharge contrasted to at admission (P <0.001). CI of (IVC, RT IJV and LT IJV)  were significantly greater at discharge compared to at admission. 

Conclusions: Assessment of diameters of IVC, RT IJV and LT IJV showed  strong positive correlation with invasive CVP. CI of IVC, RT IJV and also LT IJV showed strong negative correlation with invasive CVP. LT IJV  can be used as an indicator for follow up volume status but less sensitive than RT IJV.