Di Maria A, Siligato R, Bondanelli M, Fabbian F. Venous Doppler flow patterns, venous congestion, heart disease and renal dysfunction: A complex liaison. World J Cardiol 2024; 16(1): 5-9 [PMID: 38313388 DOI: 10.4330/wjc.v16.i1.5]
Corresponding Author of This Article
Fabio Fabbian, MD, Associate Professor, Consultant Physician-Scientist, Department of Medical Sciences, University of Ferrara, Ferrara 44124, Italy. f.fabbian@ospfe.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jan 26, 2024; 16(1): 5-9 Published online Jan 26, 2024. doi: 10.4330/wjc.v16.i1.5
Venous Doppler flow patterns, venous congestion, heart disease and renal dysfunction: A complex liaison
Alessio Di Maria, Rossella Siligato, Marta Bondanelli, Fabio Fabbian
Alessio Di Maria, Rossella Siligato, Specialized Medicines, Renal Unit, University Hospital St. Anna of Ferrara, Ferrara I-44124, Italy
Rossella Siligato, Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina I-98121, Italy
Marta Bondanelli, Department of Medical Sciences, University of Ferrara, Ferrara I-44124, Italy
Fabio Fabbian, Department of Medical Sciences, University of Ferrara, Ferrara 44124, Italy
Author contributions: Siligato R, Di Maria A, Bondanelli M, and Fabbian F contributed to this paper; Di Maria A, Siligato R, Bondanelli M, Fabbian F designed the overall concept, reviewed the literature, contributed to the discussion, wrote the initial draft, edited the subsequent versions, and approved the final version.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabio Fabbian, MD, Associate Professor, Consultant Physician-Scientist, Department of Medical Sciences, University of Ferrara, Ferrara 44124, Italy. f.fabbian@ospfe.it
Received: November 24, 2023 Peer-review started: November 24, 2023 First decision: December 7, 2023 Revised: December 15, 2023 Accepted: January 3, 2024 Article in press: January 3, 2024 Published online: January 26, 2024
Abstract
The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on. We focused our attention on venous congestion. In intensive care settings, it is now widely accepted that venous congestion is an important clinical feature worthy of investigation. Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy. Renal dysfunction could trigger or worsen fluid overload in heart disease, and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases. Fluid overload and venous congestion, including renal venous hypertension, are major determinants of acute and chronic renal dysfunction arising in heart disease. Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations, such as critical diseases, congestive heart failure, and chronic kidney disease. Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion. Cardiologists and nephrologists might use this valuable, non-invasive, bedside diagnostic tool to establish fluid status and guide clinical choices.
Core Tip: Fluid overload and venous congestion, including renal venous hypertension, play a major role in the pathogenesis of acute and chronic renal dysfunction occurring in heart disease. Physical assessment sensitivity alone to determine fluid status is scarce, limiting success in clinical decision-making. Ultrasonography and venous Doppler flow patterns evaluation is a valuable, non-invasive, bedside diagnostic tool for establishing fluid status, and guide its treatment.
