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https://tsukuba.repo.nii.ac.jp/oai
oai:tsukuba.repo.nii.ac.jp:00041807
2022-04-27T09:12:46Z
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2780:547
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3:62:5592:633
Estimation of Central Venous Pressure Using the Ratio of Short to Long Diameter from Cross-Sectional Images of the Inferior Vena Cava
瀬尾, 由広
山本, 昌良
石津, 智子
青沼, 和隆
Seo, Yoshihiro
Iida, Noriko
Yamamoto, Masayoshi
Machino-Ohtsuka, Tomoko
Ishizu, Tomoko
Aonuma, Kazutaka
© 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Background
Long-axis images of the inferior vena cava (IVC) have limitations as surrogates for IVC morphology in grading central venous pressure (CVP) by two-dimensional echocardiography (2DE), because of the various cross-sectional morphologies and the translational motion of the IVC induced by sniffing. On the basis of the relationship between venous pressure and compliance, it was hypothesized that the cross-sectional morphology of the IVC, which was obtained using three-dimensional echocardiography, might estimate CVP more accurately compared with standard grading by 2DE.
Methods
Sixty consecutive patients who underwent right-heart catheterization studies were prospectively enrolled. Echocardiography was performed <24 hours before catheterization. From three-dimensional data sets, a cross-section of the IVC was determined that was perpendicular to the long-axis reference of the IVC. Short diameter (SD), long diameter (LD), the ratio of SD to LD (S/L) as the sphericity index, and area were measured on this cross-sectional IVC image.
Results
CVP correlated moderately with SD (r = 0.69, P < .001), strongly with S/L (r = 0.75, P < .001), and modestly with area (r = 0.47, P < .001) but not with LD (r = 0.24, P = .17). The largest areas under the curve by receiver operating characteristic analyses to detect CVP ≥ 10 mm Hg were 0.98 (95% CI, 0.97–1.0; P < .001) for S/L, 0.83 for SD (95% CI, 0.74–0.94; P < .001), and 0.70 for area (95% CI, 0.56–0.84; P = .02). If a cutoff value of 0.69 for S/L was used, the sensitivity, specificity, and accuracy to detect CVP ≥ 10 mm Hg were 0.94, 0.95, and 0.95 and for CVP grading by 2DE were 0.59, 0.98, and 0.85, respectively. Estimations of CVP were more accurately reclassified using S/L rather than grading by 2DE (net reclassification improvement, 0.38; 95% CI, 0.31–0.44; P < .001).
Conclusions
S/L of an IVC cross-section measured using three-dimensional echocardiography may be a reliable parameter to estimate CVP compared with standard grading by 2DE.
Elsevier
2017-05
eng
journal article
http://hdl.handle.net/2241/00146746
https://tsukuba.repo.nii.ac.jp/records/41807
28065586
10.1016/j.echo.2016.12.002
0894-7317
AA10709494
Journal of the American Society of Echocardiography
30
5
461
467
https://tsukuba.repo.nii.ac.jp/record/41807/files/JASE_30-5.pdf
application/pdf
490.2 kB
2018-06-01