Heart Failure Clinical Trial
Official title:
Comparison of Non-invasive to Invasive Assessment of Jugular Venous Pressure
Assessment of the jugular venous pressure (JVP) is an important clinical sign and correlates
with right atrial (RA) pressure. A patient with heart failure (HF) typically has an elevated
JVP, but in cases of dehydration JVP may be low. Assessment of the JVP is key to the
management of patients with fluid overload or needing diuretics. Currently the assessment of
JVP is made by the physician by direct visualization of the neck veins. However this is
inaccurate, may vary between investigators and depends largely on the patient's habitus. The
JVP and RA pressures may also be directly measured by catheterization (a routine during right
heart catheterization), but this is an invasive procedure that is seldom performed.
A thermal movie of the external jugular vein at a specific neck position may help to measure
the JVP. In this study different modalities of JVP assessment (clinical assessment, thermal
image and invasive measurement) are to be compared
Patients scheduled for right heart catheterization at the Shaare Zedek Medical Center for
non-study related medical indications will be approached.
Non-invasive estimates of JVP will be performed independently prior to the right heart
catheterization, during the waiting period (within 2 hours) prior to catheterization. These
will include up to 2min of thermal camera recording (to be analysed offline) and a
physician's JVP evaluation. The angle of the patient's upper body will be 30-60°, the
rotation of the neck will be optimal for filming, and the neck area may be cooled to enhance
the images. Blinding to the results will be confirmed by performance with separate
investigators and separate data registration. Right heart catheterization will then be
performed and RA pressure will be recorded, as well as pulmonary and wedge pressures. JVP
measured by physician and thermal image will be matched with invasive catheterization (the
gold standard) using Bland Altman plots and Spearmann correlation and comparison between
methods will be performed.
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