Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Usefulness of Systemic Venous Ultrasound Protocols in the Prognosis of Heart Failure Patients: Results from a Prospective Multicentric Study

Marta Torres-Arrese
,
Arantzazu Mata-Martínez
,
Davide Luordo-Tedesco
,
Gonzalo García-Casasola
ORCID logo ,
Rodrigo Alonso-González
,
Esther Montero-Hernández
,
Marta Cobo-Marcos
,
Beatriz Sánchez-Sauce
,
Valentín Cuervas-mons
,
Yale Tung-Chen
*
Version 1 : Received: 30 December 2022 / Approved: 3 January 2023 / Online: 3 January 2023 (07:33:46 CET)

A peer-reviewed article of this Preprint also exists.

Torres-Arrese, M.; Mata-Martínez, A.; Luordo-Tedesco, D.; García-Casasola, G.; Alonso-González, R.; Montero-Hernández, E.; Cobo-Marcos, M.; Sánchez-Sauce, B.; Cuervas-Mons, V.; Tung-Chen, Y. Usefulness of Systemic Venous Ultrasound Protocols in the Prognosis of Heart Failure Patients: Results from a Prospective Multicentric Study. J. Clin. Med. 2023, 12, 1281. Torres-Arrese, M.; Mata-Martínez, A.; Luordo-Tedesco, D.; García-Casasola, G.; Alonso-González, R.; Montero-Hernández, E.; Cobo-Marcos, M.; Sánchez-Sauce, B.; Cuervas-Mons, V.; Tung-Chen, Y. Usefulness of Systemic Venous Ultrasound Protocols in the Prognosis of Heart Failure Patients: Results from a Prospective Multicentric Study. J. Clin. Med. 2023, 12, 1281.

Abstract

Mortality and readmission rates for decompensated acute heart failure (AHF) is overall increasing and risk stratification might be challenging. We sought to evaluate the prognostic role of systemic venous ultraso-nography in patients hospitalized for AHF. We prospectively recruited 74 AHF patients with a NT-proBNP level above 500 pg/mL. Then, a multiorgan ultrasound assessment (lung, inferior vena cava, Doppler of hepatic, portal, intrarenal and femoral veins) were performed at admission, discharge, and follow-up (for 90 days). An intrarenal monophasic pattern (AUC 0.923, Sn 90%, Sp 81%, PPV 43%, NPV 98%), a portal pulsatility >50% (AUC 0.749, Sn 80%, Sp 69%, PPV 30%, NPV 96%) and a VExUS score of 3 (AUC 0.885, sensitivity 80%, specificity 75%, PPV 33%, NPV 96%) predicted death during hospitalization. An IVC above 2 cm (AUC 0.758, Sn 93.l% and Sp 58.3) and the presence of an intrarenal monophasic pattern (AUC 0. 834, sensitivity 0.917, specificity 67.4%) in the follow-up visit predicted AHF related readmission. Addi-tional scans during hospitalization or calculate a VExUS score probably adds unnecessary complexity to the assessment of AHF patients. In conclusion, VExUS score does not contribute to guide therapy or the predic-tion of complications, compared to the presence of an inferior vena cava greater than 2 cm, a venous mo-nophasic intrarenal pattern or a pulsatility > 50% of the portal vein in AHF patients. Early and multidisci-plinary follow-up visit remains necessary to improve prognosis of this highly prevalent disease.

Keywords

point-of-care ultrasound; Doppler ultrasound; VExUS; venous excess ultrasonography; acute heart failure; portal vein; hepatic vein; intrarenal vein; inferior vena cava

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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