• Hypotension
• hypovolemia
• intracranial aneurysms
• subarachnoid hemorrhage
• transthoracic echocardiography

• Humans
• Hypovolemia/diagnostic imaging
• Hypovolemia/etiology
• Subarachnoid Hemorrhage/surgery
• Subarachnoid Hemorrhage/complications
• Subarachnoid Hemorrhage/diagnostic imaging
• Middle Aged
• Adult
• Male
• Female
• Echocardiography/methods
• Prospective Studies
• Aged
• Young Adult
• Adolescent
• Hypotension

• heart
• heart failure
• hospital mortality
• intensive care units
• software design

• Doppler vein signals
• POCUS
• echocardiography
• left ventricular assisted device

• Congestion
• Heart failure
• Ultrasound

• Humans
• Heart Failure/physiopathology
• Heart Failure/diagnostic imaging
• Heart Failure/complications
• Ultrasonography/methods
• Echocardiography/methods

• Università di Pisa

• Right atrial pressure
• echocardiography
• inferior vena cava
• prognosis
• tricuspid regurgitation

• Central venous pressure
• Children
• Hemodynamics
• Hepatic vein Doppler ultrasound
• Point-of-care ultrasonography

• Humans
• Central Venous Pressure/physiology
• Hepatic Veins/diagnostic imaging
• Male
• Female
• Infant
• Respiration, Artificial/methods
• Ultrasonography, Doppler/methods
• Child, Preschool
• Child
• Prospective Studies
• Critical Illness
• Sensitivity and Specificity

• Point-of-care ultrasound
• VExUS
• Venous congestion
• Venous excess ultrasound

• Mahidol University

• Echocardiography
• Hepatic vein
• Liver disease
• Liver fibrosis
• Right atrial pressure
• Right atrial pressure estimation
• Superior vena cava

• Humans
• Female
• Male
• Hepatic Veins/diagnostic imaging
• Hepatic Veins/physiopathology
• Vena Cava, Superior/diagnostic imaging
• Vena Cava, Superior/physiopathology
• Middle Aged
• Blood Flow Velocity/physiology
• Aged
• Atrial Pressure/physiology
• Reproducibility of Results
• Predictive Value of Tests
• Heart Atria/diagnostic imaging
• Heart Atria/physiopathology
• Echocardiography, Doppler/methods

• Humans
• Atrial Pressure
• Echocardiography
• Veins
• Ultrasonography, Doppler
• Cardiac Catheterization

• atria
• cardiomyopathy
• contractility
• myofilament
• sarcomere

• Sarcomeres/metabolism
• Myofibrils/physiology
• Heart Atria/metabolism
• Atrial Function
• Myocardial Contraction/physiology
• Protein Isoforms/metabolism

• R56 HL165137 NHLBI NIH HHS
• K99 HL141698 NHLBI NIH HHS
• R00 HL141698 NHLBI NIH HHS
• HL165137 HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)
• HL141698 HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)

• Humans
• Ultrasonography
• Obesity/complications

• Critical care
• Doppler
• Echocardiography
• Ultrasound

• Humans
• Ultrasonography/methods
• Intensive Care Units
• Echocardiography/methods
• Critical Care/methods

• Inferior vena cava diameter
• cardiac catheterization
• mean right atrial pressure
• paediatric heart transplant

• Adult
• Humans
• Child
• Natriuretic Peptide, Brain
• Retrospective Studies
• Echocardiography
• Heart Transplantation
• Atrial Pressure
• Vena Cava, Inferior/diagnostic imaging

• Continuous Renal Replacement Therapy
• Extracorporeal blood purification
• Hemodynamic monitoring
• Point-of-care ultrasound
• Ultrafiltration

• Humans
• Continuous Renal Replacement Therapy/adverse effects
• Prospective Studies
• Hemodynamic Monitoring/adverse effects
• Pandemics
• Acute Kidney Injury/therapy
• Acute Kidney Injury/etiology
• Renal Replacement Therapy/adverse effects
• Water-Electrolyte Imbalance/complications
• Heart Failure/complications
• Cell Proliferation

• albumin
• cirrhosis
• critical care
• fluid resuscitation
• shock

• Humans
• Resuscitation/methods
• Liver Cirrhosis
• Fluid Therapy/methods

• R38 HL143584 NHLBI NIH HHS

Congestive nephropathy is kidney dysfunction caused by the impact of elevated venous pressures on renal hemodynamics. As a part of cardiorenal syndrome, the diagnosis is usually made based on history and physical examination, with findings such as jugular venous distension, a third heart sound, and vital signs as supporting findings. More recently, however, these once though objective measures have come under scrutiny for their accuracy. At the same time, bedside ultrasound has increased in popularity and is routinely being used by clinicians to take some of the guess work out of making the diagnosis of volume overload and venous congestion. In this mini-review, we will discuss some of the traditional methods used to measure venous congestion, describe the role of point-of-care ultrasound and how it can ameliorate a clinician’s evaluation, and offer a description of venous excess ultrasound score, a relatively novel scoring technique used to objectively quantify congestion. While there is a paucity of published large scale clinical trials evaluating the potential benefit of ultrasonography in venous congestion compared to gold standard invasive measurements, more study is underway to solidify the role of this objective measure in daily clinical practice.

• Ultrasound
• Point-of-care ultrasonography
• Doppler
• Venous excess ultrasound score
• Congestion
• Hemodynamics
• Heart failure
• Nephrology

• Doppler ultrasound
• Femoral vein
• Femoral venous stasis index
• Pulmonary hypertension
• Right atrial pressure
• Right heart catheterization

• Atrial pressure
• Heart failure
• Multidetector computed tomography
• Standing position
• Superior vena cava

• AKI
• CKRT
• POCUS
• acute kidney injury and ICU nephrology
• dialysis
• fluid management
• fluid overload
• fluid removal
• point-of-care
• renal replacement therapy
• ultrasonography

• Humans
• Critical Illness/therapy
• Goals
• Acute Kidney Injury/therapy
• Continuous Renal Replacement Therapy
• Renal Replacement Therapy/adverse effects

• R01 DK128208 NIDDK NIH HHS
• P30 DK079337 NIDDK NIH HHS
• R01 HL148448 NHLBI NIH HHS

• cesarean section
• hemodynamics
• inferior vena cava collapse index

•

Volume status assessment by physical exam in heart failure patients is often inaccurate.

Accurate volume status assessment is crucial for the treatment of acute decompensated heart failure (ADHF). Volume status assessment by physical exam is often inaccurate, necessitating invasive measurement with right heart catheterization (RHC), which carries safety, pragmatic (scheduling, holding anticoagulants, etc.), and financial burdens. Therefore, a reliable, non-invasive, cost-effective alternative is desired. Previously, we developed an ultrasound (US) based technique to measure internal jugular vein (IJV) compliance during RHC which was used for single time point central venous pressure (CVP) predictions. We now aim to apply this technique to track acute changes in CVP during diuresis for ADHF in patients with an in-dwelling pulmonary artery catheter (PAC).

We used an observational, prospective study design and recruited 15 patients from the cardiac critical unit (CCU) being treated for ADHF (systolic or diastolic) with intravenous (IV) diuretics with/without inotropic agents who underwent Swan- Ganz catheter/PAC insertion for continuous CVP monitoring. 13 of 15 patients received milrinone infusions. US images of the IJV were obtained at end-expiration and during the strain phase of Valsalva at multiple 2–3 hours intervals. Change in IJV cross-sectional area (CSA) (ImageJ) was used as a measure of IJV compliance. Patients unable to perform the Valsalva maneuver were excluded.

Calculated percentage change (%Δ) in CSA of IJV was plotted against CVP. An inverse relationship was observed between CVP and %Δ in CSA of IJV. The data was fit with a polynomial regression curve (R² = 0.36, root mean square error = 3.19). Fivefold cross-validation showed a stable model for predicting CVP based on CSA (R² = 0.31, root mean square error = 3.18)

Serial portable US assessment of IJV compliance can act as a surrogate measure of CVP and, therefore, can provide reliable information on acute hemodynamic changes in ADHF.

• Handheld ultrasound
• Heart failure
• Inferior vena cava
• Right internal jugular
• Volume status

The role of venous congestion in abnormal kidney function is being increasingly recognized. It is well known that unresolved congestion is associated with adverse kidney and overall outcomes in patients with heart failure. Similarly, any condition that leads to elevated central venous pressure, such as pulmonary hypertension, can result in impaired kidney perfusion by increasing its afterload. Point-of-care ultrasonography (POCUS) enables the clinician to objectively assess hemodynamics at the bedside and, thereby, guide patient management. Lung POCUS has received widespread attention in the recent past because of the relative ease of the technique, but it reflects only left heart pressures and not venous congestion. Although inferior vena cava POCUS is used to estimate right atrial pressure, its isolated use cannot demonstrate organ congestion. Moreover, it is associated with several technical and conceptual limitations. Recently, venous excess Doppler ultrasound has emerged as a tool to assess venous congestion at the organ level in real time. Severe flow abnormalities in hepatic, portal, and kidney parenchymal veins have shown to predict the risk of congestive kidney injury. In addition, it helps to objectively monitor the efficacy of decongestive therapy. In this review, we provide a brief overview of various components of venous excess Doppler ultrasound and share our perspective on incorporating this novel tool in nephrology practice.

• biomarkers
• congestion
• echocardiography
• heart failure
• pulmonary ultrasound
• vascular ultrasound

• Central venous pressure
• Clinical decision-making
• Echocardiography
• Inferior vena cava

• aortic valve
• cardiac magnetic resonance imaging
• computed tomography
• echocardiography
• expert’s consensus
• mitral valve
• pulmonary valve
• tricuspid valve
• valvular regurgitation

• Biomarcadores
• Biomarkers
• Congestion
• Congestión
• Diuretic therapy
• Diuréticos
• Heart failure
• Insuficiencia cardiaca

• Diuretics/therapeutic use
• Heart Failure/drug therapy
• Humans
• Sodium
• Water
• Water-Electrolyte Imbalance/etiology
• Water-Electrolyte Imbalance/therapy

• echocardiography
• right atrial pressure
• right atrial pressure estimation
• subcostal approach
• superior vena cava
• supraclavicular approach

• coronary sinus
• echocardiography
• inferior vena cava
• right atrial pressure
• right heart catheterization

Background: There have been no systemic studies about right heart filling pressure and right ventricular (RV) distensibility in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to explore combinations of echocardiographic indices to assess the stages of RV diastolic dysfunction.

Methods and Results: We recruited 32 healthy volunteers and 71 patients with CTEPH. All participants underwent echocardiography, cardiac catheterization (in patients with CTEPH), and a 6-min walk test (6MWT). The right atrial (RA) end-systolic area was adjusted for body surface area (BSA) (indexed RA area). RV global longitudinal diastolic strain rates (SRs) and RV ejection fraction (EF) were measured by speckle tracking and three-dimensional echocardiography (3D echo), respectively. All 71 patients with CTEPH underwent pulmonary endarterectomy. Of the 71 patients, 52 (73%) had decreased RV systolic function; 12 (16.9%), 26 (36.6%), and 33 (46.5%) patients had normal RV diastolic pattern, abnormal relaxation (stage 1), and pseudo-normal patterns (stage 2), respectively. The receiver operating characteristic curve analysis showed that the optimal cut-off values of early diastolic SR <0.8 s⁻¹ and indexed RA area > 8.8 cm²/BSA had the best accuracy in identifying patients with RV diastolic dysfunction, with 87% sensitivity and 82% specificity. During a mean follow-up of 25.2 months after pulmonary endarterectomy, the preoperative indexed RA area was shown as an independent risk factor of the decreased 6MWT distance.

Conclusions: Measuring early diastolic SR and indexed RA area would be useful in stratifying RV diastolic function.

• chronic thromboembolic pulmonary artery hypertension
• early diastolic strain rate
• indexed right atrial area
• right heart filling pressure
• right ventricular diastolic dysfunction

• Inferior vena cava diameter
• Respiratory variation
• Right atrial pressure

Background: Hepatic injury secondary to congestive heart failure is well described, however, only limited data exist about the possible impact of acute cardiac dysfunction on the liver. We aimed to explore the possible cardio-hepatic interaction in patients with myocardial infarction. Material and methods: A single-center retrospective cohort study of 1339 ST elevation myocardial infarction (STEMI) patients who underwent primary coronary intervention between June 2012 to June 2019. Echocardiographic examinations were performed to assess left ventricular ejection fraction (LVEF) and central venous pressure (CVP). Patients were stratified into four groups by their LVEF and CVP levels: LVEF ≥ 45%, and CVP ≤ 10 mm/Hg (n = 853), LVEF < 45% with CVP ≤ 10 mm/Hg (n = 364), EF ≥ 45%, with CVP > 10 mm/Hg (n = 61), and LVEF < 45% with CVP > 10 mm/Hg (n = 61). Patients were evaluated for baseline and peak liver enzymes including alanine transaminase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), and bilirubin. Results: Greater severity of cardiac dysfunction was associated with worse elevation of liver enzymes. We found a graded increase in mean levels of maximal ALT, first and maximal ALP, and first and maximal GGT values. Using propensity score matching to estimate the impact of cardiac dysfunction on liver injury, we chose patients with the worst cardiac function parameters: (LVEF < 45% and CVP >10 mm/Hg; n = 61) and compared them to matched patients with better cardiac function (n = 45). We found a significantly higher level of maximal ALT, first and maximal ALP, and GGT values in the group with the worst cardiac function parameters (p < 0.05). Conclusions: Among patients with STEMI, the combination of decreased LVEF and venous congestion was associated with liver enzymes elevation suggesting a possible cardio-hepatic syndrome.

• ACLI
• STEMI
• acute heart failure (AHF)
• acute liver injury
• cardiac hepatopathy
• cardio hepatic
• liver enzymes

• Congestion
• Critical care
• Doppler
• Heart failure
• Hemodynamics
• Nephrology
• Point of care ultrasonography
• Ultrasound
• VExUS

• Biomarcadores
• Biomarkers
• Congestion
• Congestión
• Diuretic therapy
• Diuréticos
• Heart failure
• Insuficiencia cardiaca

• Fluid management
• Gabon
• Point-of-care ultrasound
• Severe malaria
• Volume status

• Cardio-renal syndrome
• Intrarenal venous Doppler
• POCUS
• Portal vein pulsatility
• Venous congestion

• acute myocardial infarction
• risk prediction
• score system
• short-term mortality

• Aged
• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• China/epidemiology
• Heart Failure
• Humans
• Male
• Middle Aged
• Myocardial Infarction/diagnosis
• Percutaneous Coronary Intervention
• Risk Assessment
• Risk Factors
• Rural Population
• Stroke Volume
• Ventricular Function, Left

• 202020007 Linyi City's 2020 Science and Technology Innovation Development Plan (medical category)

• echocardiograghy
• heart failure
• pulmonary hypertension
• right atrial pressure
• right heart catheterization

• Echocardiography
• Fluid overload
• Haemodialysis
• Hydration status
• Lung ultrasound

• B-lines
• Heart failure
• Inferior vena cava
• Intrarenal venous flow
• Jugular vein
• Ultrasound

• atrial septal defect
• circulatory equilibrium
• hemodynamics
• prediction

• Central venous pressure
• Haemodynamics
• Heart failure
• Speckle tracking echocardiography
• Strain imaging

Highly trained athletes running 42 km or more demonstrate elevated cardiac biomarkers, ventricular dysfunction, and decreased glomerular filtration rate (GFR). Whether similar changes occur in the much larger population of recreational runners following half‐marathon distance running is unclear.

Recreational runners exhibit changes in myocardial and renal biomarkers, including ventricular strain, after a half‐marathon treadmill run.

10 recreational subjects (mean age 36.5 ± 6.5 years) ran 21 km on a treadmill (mean completion time 121.6 ± 16.1 minutes). Serum high‐sensitivity troponin T (hsTnT), amino‐terminal pro‐brain natriuretic peptide (NT‐proBNP), creatinine, and neutrophil gelatinase‐associated lipocalin (NGAL) were measured prior to, 1 hour post‐, and 24 hours post‐exercise. Pre‐ and post‐exercise echocardiograms were performed.