Abstract
Background
Handheld ultrasound devices are increasingly used by clinicians for their ease of
use and portability. Their utility for estimating right atrial pressure (RAP) is poorly
described.
Methods
This prospective study enrolled 50 consecutive patients presenting for outpatient
right heart catheterization (RHC). A handheld ultrasound device was used to measure
inferior vena cava size and collapsibility and estimate RAP to be 3, 8, or 15 mmHg
according to American Society of Echocardiography recommendations for cardiac chamber
quantification. Invasive pressure measurements were then performed using RHC. Spearman's
correlation and linear regression analysis were used to evaluate the association between
estimated RAP using ultrasound and invasive RAP.
Results
Fifty patients were enrolled (mean age 68 ± 8 years). Estimated RAP by ultrasound
was significantly associated with invasive RAP (r 0.80; R2 0.63; 95% confidence interval, 0.61-0.96; P < .001). The correlation was stronger when RHC was indicated for evaluation of heart
failure (r 0.88; P < .001) compared with other indications (r 0.69; P < .001). An estimated RAP of 3, 8, and 15 mmHg by ultrasound had a sensitivity and
specificity of predicting an invasive RAP of 0-5, 6-10, and > 10 mmHg of 88% and 76%,
56% and 88%, and 81% and 97%, respectively, with overall accuracy of 80%, 76%, and
92%, respectively. Estimated RAP also correlated with invasive pulmonary capillary
wedge pressure (r 0.64; R2 0.41; 95% confidence interval, 0.26-0.54; P < .001).
Conclusions
Handheld ultrasonography is a useful tool that can accurately estimate RAP at the
bedside.
Keywords
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References
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Article Info
Publication History
Published online: May 27, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
Published by Elsevier Inc.
