Peripheral venous pulsatility detected by Doppler method for diagnosis of right heart failure.

This study shows that peripheral venous flow detected by Doppler ultrasound becomes synchronously pulsatile with heart beats as soon as central venous pressure (CVP) is above 7 mm Hg. CVP was above 7 mm Hg in 13 among 46 patients. Clinical signs of right heart failure were detectable in only 7 of these 13 patients (sensitivity 54%), whereas peripheral venous flow was pulsatile in 12 of them (sensitivity 92%). In 4 patients with a normal CVP, peripheral venous flow was also pulsatile; all of them suffered from valvular heart disease with left ventricle ejection fraction below 60% in 3 of them. The detection of a pulsative peripheral venous blood flow constitutes an early sign of right heart failure, more sensitive than clinical evaluation, and probably even more than CVP.