Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. May 26, 2024; 16(5): 221-225
Published online May 26, 2024. doi: 10.4330/wjc.v16.i5.221
Portal vein pulsatility: An important sonographic tool assessment of systemic congestion for critical ill patients
Stavros Dimopoulos, Michael Antonopoulos
Stavros Dimopoulos, Michael Antonopoulos, Cardiac Surgery ICU, Onassis Cardiac Surgery Center, Kallithea 17674, Greece
Co-first authors: Michael Antonopoulos and Stavros Dimopoulos.
Author contributions: Antonopoulos M conceptualized the manuscript and prepared the original draft; Dimopoulos S designed, reviewed and edited the draft and supervised the process; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stavros Dimopoulos, PhD, EDIC, Director, Cardiac Surgery ICU, Onassis Cardiac Surgery Center, No. 356 L. Syggrou, Athens, 17674, Greece. stdimop@gmail.com
Received: November 30, 2023
Peer-review started: November 30, 2023
First decision: February 18, 2024
Revised: February 19, 2024
Accepted: April 1, 2024
Article in press: April 1, 2024
Published online: May 26, 2024
Processing time: 175 Days and 0.1 Hours
Abstract

In this editorial we comment on the article by Kuwahara et al, published in the recent issue of the World Journal of Cardiology. In this interesting paper, the authors showed a correlation between portal vein pulsatility ratio, examined by bedside ultrasonography, and prognosis of hospitalized patients with acute heart failure. Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination, biomarkers, central venous pressure estimation and X-rays. However, congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis. Doppler flow assessment of the abdominal veins is gaining popularity worldwide, as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

Keywords: Systemic congestion; Organ perfusion; Hemodynamics; Central venous pressure; Point of care ultrasound; Venous excess ultrasound

Core Tip: Venous excess ultrasound score incorporates the assessment of the inferior vena cava and the Doppler flow patterns of hepatic, portal and renal veins. It can provide valuable information about volume status, guide fluid management decisions in the acutely ill and obviate the deleterious effects of congestion to the peripheral organs.