Venous excess ultrasound and right heart catheterization in pre-capillary pulmonary hypertension.

AIMS: Venous congestion is an important determinant of organ dysfunction in patients with pulmonary hypertension. Currently, there are no optimal methods for non-invasive assessment of venous congestion. We aimed to evaluate the accuracy of the recently described venous excess ultrasound grading system (VExUS) to determine the presence of venous congestion in patients with precapillary pulmonary hypertension compared to right heart catheterization.

METHODS

We included patients with precapillary pulmonary hypertension undergoing right heart catheterization. VExUS was performed by trained cardiologists simultaneous with catheterization. Correlation and simple logistic regression between invasive hemodynamic measurement and VExUS was performed.

RESULTS

Forty-nine patients with precapillary pulmonary hypertension were included. A significant correlation between VExUS and right atrial pressure (RAP) was found (R = 0.70, p < 0.001). VExUS was an excellent predictor of RAP > 10 mmHg (AUC 0.93, p < 0.001).

CONCLUSION

Our study provides evidence that VExUS score is a reliable, non-invasive method for assessing right atrial pressure in patients with pre-capillary PH.