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

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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.

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Acknowledgements

The authors would like to thank Pr. Claire Bouleti for her valuable help and advice regarding the conception of the study.

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Correspondence to Jean-Eudes Trihan.

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Human Subjects’ Statement

After written information regarding this study, no patient was opposed to anonymously participating in this study. Written consent from the participants was not required to participate in this study as all tests performed were considered part of their standard of care, in accordance with the national legislation and institutional requirements. All procedures followed were in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Croquette, M., Puyade, M., Montani, D. et al. Diagnostic Performance of Pulsed Doppler Ultrasound of the Common Femoral Vein to Detect Elevated Right Atrial Pressure in Pulmonary Hypertension. J. of Cardiovasc. Trans. Res. 16, 141–151 (2023). https://doi.org/10.1007/s12265-022-10276-3

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