{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T10:50:51Z","timestamp":1782384651589,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Although chronic venous insufficiency is often treated as a localized problem, it is a systemic condition that can negatively affect cardiac hemodynamics. This study investigates the associated effects of eliminating the pathologic venous reservoir on right ventricular (RV) functions, systolic pulmonary artery pressure (sPAP), and inferior vena cava (IVC) diameter in patients undergoing endovenous radiofrequency ablation (RFA) for severe great saphenous vein (GSV) insufficiency. Methods: This retrospective observational study included 154 patients who presented between September 2023 and May 2025 with GSV insufficiency (CEAP C3-C4b) and underwent endovenous RFA. Patients with major cardiopulmonary diseases were strictly excluded. Preoperative and 6-month postoperative transthoracic echocardiography records were analyzed to evaluate RV diastolic diameter, tricuspid annular plane systolic excursion (TAPSE), sPAP, the TAPSE\/sPAP ratio, and IVC diameter. Results: At 6 months post-RFA, compared to preoperative values, a significant decrease was detected in the mean sPAP (14.7 \u00b1 2.5 vs. 11.8 \u00b1 1.8 mmHg, p &lt; 0.001) and IVC diameter (2.1 \u00b1 0.2 vs. 1.9 \u00b1 0.2 cm, p &lt; 0.001). Furthermore, significant improvements were observed in TAPSE (20.0 \u00b1 2.0 vs. 21.5 \u00b1 1.8 mm, p &lt; 0.001) and the TAPSE\/sPAP ratio (1.36 \u00b1 0.15 vs. 1.82 \u00b1 0.18 mm\/mmHg, p &lt; 0.001). Conclusions: Endovenous RFA is associated with favorable changes in right heart parameters. Eliminating pathologic extremity blood pooling may optimize venous return kinetics and subclinically improve right ventricular\u2013pulmonary arterial coupling.<\/jats:p>","DOI":"10.3390\/jcdd13070294","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:14:12Z","timestamp":1782375252000},"page":"294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Endovenous Radiofrequency Ablation on Right Ventricular Functions and Pulmonary Hemodynamics in Superficial Venous Insufficiency"],"prefix":"10.3390","volume":"13","author":[{"given":"Mehmet","family":"Aslan","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Alanya Education and Research Hospital, Antalya 07400, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5977-9505","authenticated-orcid":false,"given":"Mustafa","family":"\u00d6zg\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Alanya Education and Research Hospital, Antalya 07400, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umut Serhat","family":"Sanr\u0131","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Alaaddin Keykubat University, Antalya 07400, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O\u011fuz","family":"Karahan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, Alaaddin Keykubat University, Antalya 07400, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s10741-025-10508-z","article-title":"Chronic venous insufficiency in heart failure: Exploring a reciprocal influence on cardiovascular health","volume":"30","author":"Damay","year":"2025","journal-title":"Heart Fail. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/1708538117723201","article-title":"Primary pulmonary arterial hypertension with preserved right ventricular function leads to lower extremity venous insufficiency","volume":"26","author":"Aldemir","year":"2018","journal-title":"Vascular"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s10741-022-10282-2","article-title":"Right ventricular failure in left heart disease: From pathophysiology to clinical manifestations and prognosis","volume":"28","author":"Dini","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e578","DOI":"10.1161\/CIR.0000000000000560","article-title":"Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement from the American Heart Association","volume":"137","author":"Konstam","year":"2018","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s12630-025-02911-9","article-title":"Prevalence of abnormal common femoral vein pulsatility on Doppler ultrasound in patients undergoing cardiac surgery and its association with adverse events: A prospective cohort study","volume":"72","author":"Huard","year":"2025","journal-title":"Can. J. Anaesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s40477-023-00819-y","article-title":"Prognostic value of Doppler waveform analysis of common femoral vein in septic patients: A prospective cohort study","volume":"26","author":"Dias","year":"2023","journal-title":"J. Ultrasound"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4208","DOI":"10.1093\/eurheartj\/ehx003","article-title":"Diagnosis and management of acute deep vein thrombosis: A joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function","volume":"39","author":"Mazzolai","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_8","first-page":"350","article-title":"Unlocking the Potential of VExUS in Assessing Venous Congestion: The Art of Doing It Right","volume":"14","author":"Koratala","year":"2024","journal-title":"Cardiorenal Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e009047","DOI":"10.1161\/CIRCIMAGING.119.009047","article-title":"Validation of the Tricuspid Annular Plane Systolic Excursion\/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension","volume":"12","author":"Tello","year":"2019","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.bja.2018.09.028","article-title":"High postoperative portal venous flow pulsatility indicates right ventricular dysfunction and predicts complications in cardiac surgery patients","volume":"122","author":"Eljaiek","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"01027-2024","DOI":"10.1183\/23120541.01027-2024","article-title":"Femoral venous stasis index predicts elevated right atrial pressure and mortality in pulmonary hypertension","volume":"11","author":"Croquette","year":"2025","journal-title":"ERJ Open Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s12265-022-10276-3","article-title":"Diagnostic Performance of Pulsed Doppler Ultrasound of the Common Femoral Vein to Detect Elevated Right Atrial Pressure in Pulmonary Hypertension","volume":"16","author":"Croquette","year":"2023","journal-title":"J. Cardiovasc. Transl. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13089-023-00321-w","article-title":"Femoral vein pulsatility: A simple tool for venous congestion assessment","volume":"15","author":"Bhardwaj","year":"2023","journal-title":"Ultrasound J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s44158-025-00283-6","article-title":"Dual doppler dynamics: Integrating femoral venous doppler and VExUS for predicting organ dysfunction in acute heart failure","volume":"5","author":"Bhardwaj","year":"2025","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40635-026-00856-x","article-title":"Femoral vein Doppler ultrasound for assessing venous congestion and right heart function: A scoping review","volume":"14","author":"Melo","year":"2026","journal-title":"Intensive Care Med. Exp."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"112636","DOI":"10.4330\/wjc.v18.i1.112636","article-title":"Extended venous excess ultrasound: A promising addition to point-of-care ultrasound-based venous congestion assessment","volume":"18","author":"Koratala","year":"2026","journal-title":"World J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s13613-025-01609-x","article-title":"Ultrasound indicators of organ venous congestion: A narrative review","volume":"15","author":"Bitar","year":"2025","journal-title":"Ann. Intensive Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jacc.2008.05.068","article-title":"Importance of venous congestion for worsening of renal function in advanced decompensated heart failure","volume":"53","author":"Mullens","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1002\/ehf2.14233","article-title":"Adaptive versus maladaptive right ventricular remodelling","volume":"10","author":"Rako","year":"2023","journal-title":"ESC Heart Fail."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1113\/EP088657","article-title":"The influence of increased venous return on right ventricular dyssynchrony during acute and sustained hypoxaemia","volume":"106","author":"Ewalts","year":"2021","journal-title":"Exp. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Giangregorio, F., Centenara, E., Mazzocchi, S., Gerra, L., Tursi, F., Imberti, D., and Aschieri, D. (2025). Assessing Venous Congestion in Acute and Chronic Heart Failure: A Review of Splanchnic, Cardiac and Pulmonary Ultrasound: Part 1: Conventional B-Mode, Colordoppler, and Vexus Protocol. J. Clin. Med., 14.","DOI":"10.20944\/preprints202510.0927.v1"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Giangregorio, F., Centenara, E., Mazzocchi, S., Gerra, L., Tursi, F., Imberti, D., and Aschieri, D. (2026). Assessing Venous Congestion in Heart Failure: A Review of Splanchnic, Cardiac, and Pulmonary Ultrasound: Part 2: Contrast-Enhanced Ultrasound and Shear Wave. J. Clin. Med., 15.","DOI":"10.3390\/jcm15031111"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Torres-Arrese, M., Barber\u00e1-Rausell, P., Li-Zhu, J.O., Salas-Due\u00f1as, R., Real-Mart\u00edn, A.E., Mata-Mart\u00ednez, A., Gonzalo-Moreno, B., N\u00fa\u00f1ez, J.H., Luordo, D., and Cano, J.G.S. (2024). The Cardiac Pulsed Wave Doppler Pattern of the Common Femoral Vein in Diagnosing the Likelihood of Severe Pulmonary Hypertension: Results from a Prospective Multicentric Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13133860"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Albani, S., Mesin, L., Roatta, S., De Luca, A., Giannoni, A., Stolfo, D., Biava, L., Bonino, C., Contu, L., and Pelloni, E. (2022). Inferior Vena Cava Edge Tracking Echocardiography: A Promising Tool with Applications in Multiple Clinical Settings. Diagnostics, 12.","DOI":"10.3390\/diagnostics12020427"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/294\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T10:24:35Z","timestamp":1782383075000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":24,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcdd13070294"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13070294","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]}}}