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However, because of its low sensitivity, lower limb venous Doppler imaging cannot be used to screen for right-sided heart failure. The sensitivity of lower limb venous Doppler imaging for detecting right-sided heart failure as determined by right atrium pressure measurement was 46%, specificity was 94%, positive predictive value was 94%, negative predictive value was 50%, and accuracy was 65%.ĬONCLUSION: Pulsatile lower limb venous Doppler waveform correlates well with right-sided heart failure, as indicated by a right atrium pressure measurement of more than 8 mm Hg. We found a statistically significant correlation between the presence of these abnormal waveforms and elevated right atrium pressure.
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RESULTS: Of 51 patients, 17 (33%) had pulsatile lower limb venous Doppler flow waveforms and 33 (65%) had elevated right atrium pressure. A right atrium pressure of more than 8 mm Hg was considered elevated. If the body didn’t have the ability to clot blood, people would bleed to death after a minor cut. Eventually, the clot forms a protective scab over a healing wound. A Doppler waveform was considered pulsatile when it had a cyclic retrograde component. Venous Blood Clots (Thrombi, DVT) Blood clotting is a natural process in which blood cells and strands of fibrin clump together to stop bleeding after a blood vessel has been injured. The findings were correlated with the presence or absence of right-sided heart failure as determined by right atrium pressure measurement. Data from only the common femoral vein were included in our analysis because this vessel was the least involved with thrombosis. In the study, we evaluated the three major veins of the lower limb (the common femoral, superficial femoral, and popliteal) by venous Doppler imaging. In 18 of these, the right atrium pressure was measured within 1 week, 31 within 2 weeks, 42 within 3 weeks, and 51 within 4 weeks. The remaining 51 patients constituted the study subjects. Six other patients were also excluded because the time difference between the Doppler and the correlative studies was more than 4 weeks. Seventeen patients were excluded because of thrombosis in the common femoral vein. Of these, 74 had right atrium pressure measurements available for correlation. MATERIALS AND METHODS: Of 429 patients who, over a 14-month period, underwent venous Doppler imaging of the lower limb to exclude deep venous thrombosis, 343 records were available for review at the time of the study. OBJECTIVE: The purpose of this study was to determine if pulsatile flow in lower limbs as seen on venous Doppler waveforms correlates with increased right atrium pressure. 1 Department of Radiology, University of Iowa College of Medicine, Iowa City 52242, USA.