• J Ultrasound Med · Jul 2020

    Meta Analysis

    Diagnosis of Acute Heart Failure Using Inferior Vena Cava Ultrasound: Systematic Review and Meta-analysis.

    • Omar S Darwish, Abdullah Mahayni, Saisha Kataria, Eric Zuniga, Lishi Zhang, and Alpesh Amin.
    • University of California Irvine Medical Center, Orange, California, USA.
    • J Ultrasound Med. 2020 Jul 1; 39 (7): 1367-1378.

    ObjectivesThe utility of bedside inferior vena cava (IVC) ultrasound (US) in the diagnosis of heart failure (HF) is unclear. The aim of this study was to determine whether IVC parameters in patients with acute heart failure (AHF) are statistically different from those without HF.MethodsThe MEDLINE database of English-language publications from 1966 to August 2018 was searched. Retrospective and prospective studies that included either IVC expiratory diameter (IVCexp ) or IVC collapsibility index (IVC-CI) values were collected in patients with and without HF. to determine whether there was a statistical difference in the IVC parameters between these groups.ResultsA total of 27 articles with a total of 1472 patients with AHF were included. The standard mean differences for the IVCexp and IVC-CI for the control group versus the AHF group were found to be statistically significant (P < .0001). The combined mean IVCexp values were 15.11 mm (95% confidence interval [CI], 14.19-16.02 mm) for the control group and 20.26 mm (95% CI, 14.82-25.71 mm) for the AHF group. The combined mean IVC-CI values were 61.6% (95% CI, 48.4%-74.7%) for the control group and 30.5% (95% CI, 26.4%-34.6%) for the AHF group.ConclusionsBedside IVC US showed that a statistically significant difference existed in the IVC parameters between patients with and without AHF. Based on mean calculations, an IVCexp of greater than 2.0 cm and an IVC-CI of less than 30% are reasonable cutoffs to suggest that a patient with acute dyspnea is more likely to have AHF than a non-AHF condition. Given the high degree of heterogeneity across the studies and the high risk of bias, larger randomized studies are warranted to explore the use of IVC US in patients with HF.© 2020 by the American Institute of Ultrasound in Medicine.

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