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[Venous hum and innominate vein flow velocity in chronic anemia: a pulsed Doppler echocardiographic study]
T Shiota1, T Sakamoto, K Amano
1Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
Insights
The cervical venous hum, often heard in chronic anemia patients, is linked to lower hemoglobin levels and increased innominate vein blood flow velocity. This finding aids in diagnosing anemia non-invasively.
Area of Science:
- Cardiovascular Physiology
- Hematology
- Medical Acoustics
Context:
- Chronic anemia is associated with various clinical signs, including the cervical venous hum.
- The hemodynamic basis of this murmur has not been fully elucidated.
- Understanding these correlates can improve diagnostic capabilities for anemia.
Purpose:
- To investigate the hemodynamic factors associated with the cervical venous hum in patients with chronic anemia.
- To compare flow velocities in the innominate vein between anemic patients and healthy controls.
- To determine the relationship between hemoglobin levels and venous hum characteristics.
Summary:
- A study of 14 anemic patients and 14 controls revealed the cervical venous hum was present in sitting anemic patients (Hb < 9 g/dl).
- Pulsed Doppler echocardiography showed significantly higher peak innominate vein velocity in anemic patients with venous hum compared to controls (p < 0.01).
- Innominate vein peak velocity correlated significantly with hemoglobin concentration (r = 0.65, p < 0.01), and hum intensity increased with velocity.
Impact:
- The cervical venous hum is a reliable indicator of chronic anemia, correlating with reduced hemoglobin.
- This study provides hemodynamic evidence linking anemia severity to increased innominate vein blood flow.
- The findings suggest the cervical venous hum can be a valuable non-invasive marker for assessing anemia.
Abstract:
To assess the hemodynamic correlates of the cervical venous hum in patients with chronic anemia, 14 patients (mean age; 49 years, mean hemoglobin (Hb); 7.3 g/dl) and 14 control subjects (mean age; 50 years, mean Hb; 14 g/dl) without cardiac disease were studied by auscultation, phonocardiography and Doppler echocardiography in two positions (supine and sitting). Venous hum was detected in the sitting position in 11 of the 14 anemic patients whose Hb was less than 9 g/dl, and in six anemic patients in the supine position, while venous hum was absent in the control subjects in both positions. Pulsed Doppler echocardiography with the transducer in the supraclavicular fossa revealed significantly (p less than 0.01) higher peak velocity in the innominate vein in the 11 anemic patients with venous hum (supine; 71 +/- 12, sitting; 111 +/- 24 cm/sec, mean +/- SD) than in the control subjects (supine; 46 +/- 15 sitting; 76 +/- 27 cm/sec) in both positions. Intensity of venous hum increased concomitantly with increased innominate vein flow velocity when the body position was changed from supine to sitting. Peak velocity in the innominate vein correlated significantly with Hb in all study subjects (r = 0.65, p less than 0.01). In conclusion, the cervical venous hum in patients with chronic anemia is related to the hemoglobin concentration and flow velocity in the innominate vein.