[Clinical significance of measuring inferior vena cava dimension in patients with acute exacerbation of chronic heart failure].
OBJECTIVE
This study determined the clinical significance of measuring the inferior vena cava dimension in patients with heart failure.


METHODS
The subjects were 373 patients admitted due to acute exacerbation of chronic heart failure. The relationships were examined between inferior vena cava dimension in the end-expiratory phase on admission and in the stable state and etiology of heart failure, age, New York Heart Association (NYHA) functional classification in the stable state (before exacerbation), body weight, grade of tricuspid regurgitation, left ventricular end-diastolic dimension and left ventricular ejection fraction measured by two-dimensional echocardiography in the stable state and on admission, severity of lung congestion (Killip's classification) on admission, and clinical course during treatment.


RESULTS
The inferior vena cava dimension was not correlated with etiology, age, NYHA functional classification, body weight, left ventricular end-diastolic dimension or left ventricular ejection fraction, but was correlated with the grade of tricuspid regurgitation (r = 0.78, p < 0.0001 in the stable state, r = 0.60, p < 0.0001 and on admission). The severity of lung congestion did not correlate with inferior vena cava dimension on admission or the increase in inferior vena cava dimension. The increase in body weight on admission was correlated with the increase in inferior vena cava dimension (r = 0.83, p < 0.0001), but did not correlate with inferior vena cava dimension on admission. Tricuspid regurgitation grade and inferior vena cava dimension were restored to the stable state when body weight reached stable state after treatment in patients (n = 202) with inferior vena cava dimension increased by over 5 mm on admission.


CONCLUSIONS
Inferior vena cava dimension in patients with heart failure is correlated with the tricuspid regurgitation grade in the stable state and at acute exacerbation. The increase in inferior vena cava dimension between stable and exacerbated states, but not the actual value, is clinically useful to evaluate patients with acute exacerbation of chronic heart failure.
Sasaki
T
T
Division of Cardiology, Department of Cardiology and Cardiovascular Surgery, Osaka Kosei-nenkin Hospital.
Kubo
T
T
Miyamoto
T
T
Komamura
K
K
Honda
K
K
Miyatake
K
K
D002908:Chronic Disease; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D013318:Stroke Volume; D014262:Tricuspid Valve Insufficiency / Q000503:physiopathology; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology*; D016277:Ventricular Function, Left