For the assessment of right-sided heart failure, right ventricular (RV) function is
frequently evaluated, and the evaluation of central venous pressure (CVP) or right
atrial pressure (RAP), which is reflective of increased RV filling pressure or elevated
pre-load due to impaired RV function, is also commonly performed. Assessing IVC with
echocardiography is a standard non-invasive method. However, its weak point is a semiquantitative
assessment. Moreover, our report shows that body size, measured as BSA, affects the
optimal cut-off level of IVC for detecting increased RAP in Japanese HF patients.
Transient elastography is a noninvasive method to assess liver stiffness. Recently,
using transient elastography, we have revealed that liver congestion represented as
liver stiffness (LS) can estimate RAP in HF patients without liver disease. With the
analysis in patients admitted due to HF, higher LS at discharge was associated with
higher incidence of cardiac events. This result indicates that the presence of liver
congestion at discharge may associate with poor outcomes. Elevated CVP is also associated
with kidney or intestine congestion. We will introduce and discuss the association
of CVP, as an indicator of right-sided heart failure, with organ congestion.
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