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Updated: Oct 4, 2025
Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
Coronary sinus collapsibility index and inferior vena cava collapsibility index can predict right atrial pressure in
Gündüzalp Saydam1, Ali Yaşar Kılınç2, Veysel Tosun3
1Cardiology Department, Cihanbeyli State Hospital, Konya, Turkey.
Insights
Echocardiography measurements of coronary sinus (CS) and inferior vena cava (IVC) diameters and collapsibility indices correlate with right atrial pressure (RAP). These non-invasive parameters show predictive value for estimating RAP in pulmonary arterial hypertension patients.
Area of Science:
- Cardiology
- Medical Imaging
- Hemodynamics
Background:
- Right atrial pressure (RAP) is a critical hemodynamic parameter.
- Accurate RAP measurement is essential for managing various cardiovascular conditions, including pulmonary arterial hypertension (PAH).
- Non-invasive methods for estimating RAP are highly desirable to avoid invasive procedures.
Purpose of the Study:
- To investigate the relationship between echocardiographic measurements of coronary sinus (CS) and inferior vena cava (IVC) and invasively measured RAP.
- To determine the predictive value of CS and IVC diameters and collapsibility indices for estimating RAP.
Main Methods:
- Prospective study of 136 PAH patients undergoing right heart catheterization.
- Echocardiographic measurement of CS and IVC diameters and collapsibility indices (CSCI, IVCCI) prior to catheterization.
- Correlation and ROC curve analyses to assess the relationship and predictive value of echocardiographic parameters for RAP.
Main Results:
- Higher IVC and CS diameters, and lower IVCCI and CSCI, were observed in patients with RAP ≥ 10 mm Hg compared to those with RAP < 10 mm Hg (p < 0.001).
- Significant negative correlations were found between CSCI, IVCCI, and RAP.
- Optimal cut-off values for IVCCI (46.1) and CSCI (39.2) demonstrated good sensitivity and specificity in predicting elevated RAP.
Conclusions:
- Echocardiographic assessment of CS and IVC diameters and collapsibility indices are associated with invasively measured RAP.
- These non-invasive echocardiographic parameters may serve as valuable tools for estimating RAP in patients with PAH.
Background:
The aim of the study is to investigate the relationship between the diameters and collapsibility indices of coronary sinus (CS) and inferior vena cava (IVC) and invasively measured right atrial pressure (RAP), and to determine whether these parameters have predictive value on RAP.
Methods:
A total of 136 patients undergoing right heart catheterization due to pulmonary arterial hypertension were included in the study prospectively. CS diameters, IVC diameters, CS collapsibility index (CSCI), and IVC collapsibility index (IVCCI) were measured by echocardiography before catheterization. Pearson correlation analysis was used to compare the parameters. Receiver operating characteristics (ROC) curve analysis was used to determine the predictive value of the CS and IVC collapsibility indices in predicting RAP.
Results:
Patients were divided into two groups as invasively measured RAP≥10 mm Hg (n:57) and RAP < 10 mm Hg (n:79). In the group with RAP≥10 mm Hg, IVC and CS diameters were higher than in the group with RAP < 10 mm Hg, while the IVCCI and CSCI were lower (p < 0.001). A negative correlation was observed between CSCI and IVCCI and RAP. Also, a positive correlation was observed between CSCI and IVCCI. Optimal cut-off value for IVCCI was 46.1 with a sensitivity of 75%, and specificity of 79.7%. Optimal cut-off value for CSCI was 39.2 with a sensitivity of 75.4%, and specificity of 88.6%.
Conclusion:
CS and IVC diameters and collapsibility indices measured by echocardiography were found to be associated with invasively measured RAP, and may be used together for estimating RAP.
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