Correlation of right atrial pressure and blood flow velocities in the common femoral vein obtained by duplex Doppler sonography

Purpose. The purpose of this study was to correlate the right atrial pressu re with the blood flow velocity and pulsatility index (PI) values obtained with duplex Doppler sonography of the common femoral vein. Methods. Thirty consecutive patients with suspected right-sided heart failu re who had right atrial pressure measurements for correlation were included in the study. The common femoral veins were examined with duplex Doppler s onography. Irrespective of the presence or absence of clinical right-sided heart failure, patients were divided into 2 groups on the basis of their ri ght atrial pressures. The mean flow velocities and PIs in the common femora l veins of the 2 groups were compared. Results. In patients with elevated right atrial pressure (greater than or e qual to8 mm Hg), the mean minimum flow velocity +/- standard deviation (-0. 15 +/- 0.11 m/second) in the common femoral vein was significantly lower th an that in patients with normal right atrial pressure (< 8 mm Hg) (0.01 +/- 0.10 m/second) (p < 0.001). There was no significant difference in the mea n maximum flow velocities in the common femoral vein between the patients w ith elevated right atrial pressure (0.25 +/- 0.08 m/second) and the patient s with normal right atrial pressure (0.21 +/- 0.09 m/second). The mean PI i n patients with elevated right atrial pressure (7.75 +/- 3.19) was signific antly higher than the mean PI in patients with normal right atrial pressure (1.55 +/- 1.30; p < 0.001). There was a weak negative correlation between the minimum flow velocity and the pressure in the right atrium in patients with elevated right atrial pressure (p = 0.05; r= -0.4760). The amplitude o f retrograde waves seen in patients with normal right atrial pressure was s ignificantly smaller than in patients with elevated right atrial pressure ( p < 0.05). Conclusions. The association of a decreased minimum velocity, especially a negative value, and an increase in PI in the common femoral vein may indica te an elevated right atrial pressure. Sonographic assessment of retrograde flow velocity in the common femoral vein may be useful in monitoring the re sponse to medical treatment to decrease atrial pressure. (C) 2001 John Wile y & Sons, Inc. J Clin Ultrasound 29:87-91, 2001.