Vena cava compression syndrome in patients with obesity presenting with edema and thrombosis.
Obesity is a risk factor for cardiovascular disease and venous thrombosis. Previous studies have shown that in late pregnancy a compression of the inferior vena cava (VCI) leads to a hypotensive syndrome. The objective of this study was to explore the correlation between obesity and an elevated pressure in the VCI simulating obesity-induced vena cava compression syndrome.



A left and right heart catheterization was performed in 29 patients. After right atrial pressure measurement, the catheter was pulled back through the VCI, and the pressure gradient between the thoracic and abdominal vena cava was measured. We determined the correlation between the BMI and the pressure gradient.



In 29 patients, a high BMI was associated with an increased pressure gradient between the thoracic and abdominal vena cava (r = 0.66). This correlation was particularly close in patients with a BMI >30 kg/m(2) (P = 0.0008). Two patients had complications such as recurrent thrombosis, with one of them having the highest pressure gradient of 16 mm Hg.



Because mechanical obstruction of the VCI leads to an increased risk for venous thrombosis in patients with obesity, this finding needs to be considered in the decision-making for interventional treatments like bariatric surgery.
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Yvonne
Y
Linicus
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Ingrid
I
Kindermann
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Bodo
B
Cremers
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Christoph
C
Maack
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Stephan
S
Schirmer
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universität des Saarlandes und Universitätsklinikum des Saarlandes, Homburg, Germany.
Michael
M
Böhm
D000328:Adult; D016280:Atrial Function, Right; D006328:Cardiac Catheterization; D002496:Central Venous Pressure; D004487:Edema / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D011312:Pressure; D013927:Thrombosis / Q000209:etiology*; D014682:Vena Cava, Inferior / Q000502:physiology* / Q000503:physiopathology*