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Abstract

Background

Understanding venous congestion is critical to the management of many illnesses, but assessing volume status can be challenging.

The current gold standard for volume status assessment of right heart catheterization (RHC) is invasive, costly, and often unavailable.

Venous Excess Ultrasound Score (VExUS) is a novel ultrasound protocol for to assessment of venous congestion using the inferior vena cava, hepatic, portal and renal veins.

Though there is a much interest in the technique, the renal component of the exam is challenging to acquire.

For this reason we aimed to see if a modified VExUS (mVExUS) excluding the kidney component performs similarly to traditional VExUS (tVExUS) for detecting elevated right atrial pressure (RAP) as measured by RHC.

Methods

A consecutive cohort of 95 patients undergoing RHC had VExUS exams before the procedure.

Researchers compared the performance of tVExUS, mVExUS, and inferior vena cava (IVC) diameter in predicting RAP > 12 mmHg.

Results

The area under the curve (AUC) for detecting elevated RAP was similar for tVExUS (0.87) and mVExUS (0.85).

Both methods achieved high sensitivity and specificity. Agreement between tVExUS and mVExUS scores was near-perfect (Cohen’s Kappa = 0.85).

Conclusions

RV measurements should be indexed to BSA, considering sex and age, to determine RV size and enlargement.

READ MORE HERE: https://theultrasoundjournal.springeropen.com/articles/10.1186/s13089-025-00407-7

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