![]() ![]() Its use has been adopted especially in heart failure patients, but to date has had no formal validation. ![]() The presence of severe congestion (called VExUS 3) is due to an IVC of 2 cm or more and the presence of at least two severely abnormal PW-Doppler morphologies predicts acute kidney injury (AKI) in patients undergoing cardiac surgery. ![]() The moderate congestion of VExUS 2 is considerate with a IVC of at least of 2 cm and one severely abnormal pattern at PW-Doppler morphology (S-wave reversal at hepatic vein PW-Doppler, >50% of pulsatility at portal PW-Doppler and discontinuous monophasic flow with only diastolic phase at intra-renal vein PW-Doppler). Mild congestion or VExUS 1 is the presence of an IVC of almost 2 cm and any combination of normal (systolic wave greater than diastolic wave at hepatic vein PW-Doppler, pulsatility less than 30% at portal PW-Doppler, continuous pattern at intra-renal vein PW-Doppler) or mildly abnormal patterns (systolic wave smaller than diastolic wave at hepatic vein PW-Doppler, 30–50% pulsatility at portal PW-Doppler, biphasic flow at intra-renal vein PW-Doppler). The absence of congestion or VExUS 0 is considerate when IVC is smaller than 2 cm. It has been proposed as a score to evaluate systemic congestion. The venous excess ultrasonography (VExUS) score is a new method of scoring systemic congestion based on inferior vena cava (IVC) dilatation and pulsed-wave Doppler (PW-Doppler) morphology of hepatic, portal and intra-renal veins. For this reason, tools are needed to refine patient prognosis. However, the optimal follow-up frequency is unknown. Multidisciplinary programs had been implemented to tackle this high prevalence. Moreover, it is known that after diagnosis, patients with heart failure are hospitalized on average once a year. Mortality can be as high as 67% at five years after diagnosis. The incidence rate in Europe is around 5/1000 person-years in the adult population, affecting 1–2% of the adults. Early and multidisciplinary follow-up visits remain necessary for the improvement of the prognosis of this highly prevalent disease.Īcute heart failure (AHF) is a clinical syndrome whose overall incidence is increasing due to the aging of the population. In conclusion, VExUS score does not contribute to the guidance of therapy or the prediction of complications, compared with the presence of an IVC greater than 2 cm, a venous monophasic intra-renal pattern or a pulsatility > 50% of the portal vein in AHF patients. Additional scans during hospitalization or the calculation of a VExUS score probably adds unnecessary complexity to the assessment of AHF patients. 834, sensitivity 0.917, specificity 67.4%) in the follow-up visit predicted AHF-related re-admission. An IVC above 2 cm (AUC 0.758, Sn 93.l% and Sp 58.3) and the presence of an intra-renal monophasic pattern (AUC 0. An intra-renal monophasic pattern (area under the curve (AUC) 0.923, sensitivity (Sn) 90%, specificity (Sp) 81%, positive predictive value (PPV) 43%, and negative predictive value (NPV) 98%), a portal pulsatility > 50% (AUC 0.749, Sn 80%, Sp 69%, PPV 30%, NPV 96%) and a VExUS score of 3 corresponding to severe congestion (AUC 0.885, Sn 80%, Sp 75%, PPV 33%, and NPV 96%) predicted death during hospitalization. ![]() We also calculated the Venous Excess Ultrasound System (VExUS), a new score of systemic congestion based on IVC dilatation and pulsed-wave Doppler morphology of hepatic, portal and intra-renal veins. Then, multi-organ ultrasound assessments (lung, inferior vena cava (IVC), pulsed-wave Doppler (PW-Doppler) of hepatic, portal, intra-renal and femoral veins) were performed at admission, discharge, and follow-up (for 90 days). We prospectively recruited 74 AHF patients with a NT-proBNP level above 500 pg/mL. We sought to evaluate the prognostic role of systemic venous ultrasonography in patients hospitalized for AHF. Mortality and re-admission rates for decompensated acute heart failure (AHF) is increasing overall and risk stratification might be challenging. ![]()
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