Peripheral Venous Pressure Accurately Evaluates Congestion in Constrictive pericarditis

Background

The primary clinical characteristic of initial constrictive pericarditis(CP) is a cardiac decreased diastolic function, which results in venous congestion, limitation of venous return, and elevated central venous pressure(CVP).

Objective was to evaluate the relationship between peripheral venous pressure (PVP) and CVP with the aim to assess the diagnostic value of PVP in CP.

Methods

Subjects underwent invasive haemodynamic and low invasive peripheral venous pressure assessment and also underwent physical examination, biochemical indices to assess venous congestion and echocardiography to assess cardiac structure and function. Patients were divided into 2 groups by CVP > 22 cmH2O(Modal 1 defined as CVP > 22 cmH2O; Modal 2 defined as CVP≦22cmH2O).

Results

Of the 36 patients, PVP and CVP had a significant positive association (Pearson’s = 0.831; P < 0.0001), with CVP = 0.962 + 0.907PVP as the regression equation.PVP was negatively correlated with FIB-4 (Pearson’s = −0.425; P=0.01), while it was not statistically significantly correlated with Pro-BNP, albumin, serum Na, hematocrit, hemoglobin, total bilirubin, direct bilirubin, or ARPI. Modal 1 and 2 groups were separated based on CVP > 22 cmH2O. By comparing the area under the curve (AUC) of the participants’ working mass, it was definitively established that 24 cmH2O was the ideal PVP threshold for the diagnosis of CP.

Conclusions

In Constrictive Pericarditis, PVP is a reliable, minimally invasive, and accurate technique for calculating CVP, which is remarkably positively correlated with CVP. Measurement of PVP is therefore important in the assessment of congestion and helps in the early diagnosis of Constrictive Pericarditis when PVP is greater than 24 cmH2O.