{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:08:45Z","timestamp":1791464925289,"version":"4.3.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Clinical evaluation of central venous pressure is difficult, depends on experience, and is often inaccurate in patients with chronic advanced heart failure. We assessed the ultrasound-assessed internal jugular vein (JV) distensibility by ultrasound as a noninvasive tool to identify patients with normal right atrial pressure (RAP \u22647 mm\u2005Hg) in this population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We measured JV distensibility as the Valsalva-to-rest ratio of the vein diameter in a calibration cohort (N=100) and a validation cohort (N=101) of consecutive patients with chronic heart failure with reduced ejection fraction who underwent pulmonary artery catheterization for advanced heart failure therapies workup.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A JV distensibility threshold of 1.6 was identified as the most accurate to discriminate between patients with RAP \u22647 versus &gt;7 mm\u2005Hg (area under the receiver operating characteristic curve, 0.74 [95% CI, 0.64\u20130.84]) and confirmed in the validation cohort (receiver operating characteristic, 0.82 [95% CI, 0.73\u20130.92]). A JV distensibility ratio &gt;1.6 had predictive positive values of 0.86 and 0.94, respectively, to identify patients with RAP \u22647 mm\u2005Hg in the calibration and validation cohorts. Compared with patients from the calibration cohort with a high JV distensibility ratio (&gt;1.6; n=42; median RAP, 4 mm\u2005Hg; pulmonary capillary wedge pressure, 11 mm\u2005Hg), those with a low JV distensibility ratio (\u22641.6; n=58; median RAP, 8 mm\u2005Hg; pulmonary capillary wedge pressure, 22 mm\u2005Hg;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001 for both) were more likely to die or undergo a left ventricular assist device implant or heart transplantation (event rate at 2 years: 42.7% versus 18.2%; log-rank\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.034).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Ultrasound-assessed JV distensibility identifies patients with chronic advanced heart failure with normal RAP and better outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03874312.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.010973","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T10:01:54Z","timestamp":1706781714000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Estimation of Right Atrial Pressure by Ultrasound-Assessed Jugular Vein Distensibility in Patients With Heart Failure"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03874312","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-5257","authenticated-orcid":true,"given":"Enrico","family":"Ammirati","sequence":"first","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7609-9671","authenticated-orcid":true,"given":"Davide","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Cardiology Department, Galeazzi-Sant\u2019Ambrogio Hospital, Milan, Italy (D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5341-8302","authenticated-orcid":true,"given":"Giada","family":"Colombo","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Italy (G.C., M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-0464","authenticated-orcid":true,"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom (P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Gentile","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"D\u2019Angelo","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-9842","authenticated-orcid":true,"given":"Gabriella","family":"Masciocco","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Verde","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8011-3341","authenticated-orcid":true,"given":"Francesca","family":"Macera","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Brunelli","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6722-4584","authenticated-orcid":true,"given":"Lucia","family":"Occhi","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3968-4759","authenticated-orcid":true,"given":"Francesco","family":"Musca","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. Musca, E.P., A.M., F.O., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-5453","authenticated-orcid":true,"given":"Enrico","family":"Perna","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (E.A., P.G., L.D., G.M., A.V., F. Macera, D.B., L.O., F. 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