Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
BMC Cardiovasc Disord. 2021 Oct 20;21(1):506. doi: 10.1186/s12872-021-02309-7.
Currently, the accepted effective method for assessing blood volume status, such as measuring central venous pressure (CVP) and mean pulmonary artery pressure (mPAP), is invasive. The purpose of this study was to explore the feasibility and validity of the ratio of the femoral vein diameter (FVD) to the femoral artery diameter (FAD) for predicting CVP and mPAP and to calculate the cut-off value for the FVD/FAD ratio to help judge a patient's fluid volume status.
In this study, 130 patients were divided into two groups: in group A, the FVD, FAD, and CVP were measured, and in group B, the FVD, FAD, and mPAP were measured. We measured the FVD and FAD by ultrasound. We monitored CVP by a central venous catheter and mPAP by a Swan-Ganz floating catheter. Pearson correlation coefficients were calculated. The best cut-off value for the FVD/FAD ratio for predicting CVP and mPAP was obtained according to the receiver operating characteristic (ROC) curve.
The FVD/FAD ratio was strongly correlated with CVP (R = 0.87, P < 0.0000) and mPAP (R = 0.73, P < 0.0000). According to the ROC curve, an FVD/FAD ratio ≥ 1.495 had the best test characteristics to predict a CVP ≥ 12 cmHO, and an FVD/FAD ratio ≤ 1.467 had the best test characteristics to predict a CVP ≤ 10 cmHO. An FVD/FAD ratio ≥ 2.03 had the best test characteristics to predict an mPAP ≥ 25 mmHg. According to the simple linear regression curve of the FVD/FAD ratio and CVP, when the predicted CVP ≤ 5 cmHO, the FVD/FAD ratio was ≤ 0.854.
In this study, the measurement of the FVD/FAD ratio obtained via ultrasound was strongly correlated with CVP and mPAP, providing a non-invasive method for quickly and reliably assessing blood volume status and providing good clinical support.
目前，评估血容量状态的公认有效方法，如测量中心静脉压（CVP）和肺动脉平均压（mPAP），均为有创性操作。本研究旨在探讨股静脉直径（FVD）与股动脉直径（FAD）比值预测 CVP 和 mPAP 的可行性和有效性，并计算 FVD/FAD 比值的截断值，以帮助判断患者的液体容量状态。
本研究将 130 例患者分为两组：A 组测量 FVD、FAD 和 CVP，B 组测量 FVD、FAD 和 mPAP。我们通过超声测量 FVD 和 FAD。通过中心静脉导管监测 CVP，通过 Swan-Ganz 漂浮导管监测 mPAP。计算 Pearson 相关系数。根据受试者工作特征（ROC）曲线获得预测 CVP 和 mPAP 的最佳 FVD/FAD 比值截断值。
FVD/FAD 比值与 CVP（R=0.87，P<0.0000）和 mPAP（R=0.73，P<0.0000）高度相关。根据 ROC 曲线，FVD/FAD 比值≥1.495 预测 CVP≥12cmH2O 的最佳测试特征，FVD/FAD 比值≤1.467 预测 CVP≤10cmH2O 的最佳测试特征。FVD/FAD 比值≥2.03 预测 mPAP≥25mmHg 的最佳测试特征。根据 FVD/FAD 比值与 CVP 的简单线性回归曲线，当预测 CVP≤5cmH2O 时，FVD/FAD 比值≤0.854。
本研究通过超声测量 FVD/FAD 比值与 CVP 和 mPAP 高度相关，为快速可靠地评估血容量状态提供了一种非侵入性方法，为临床提供了良好的支持。
