Abstract: Background – Previous studies demonstrated hepatic venous pulsed wave Doppler variation and hepatic venous distension in patients with elevated right atrial pressures. Differences in hepatic venous waveform velocities or hepatic venous diameter may help identify patients with right-sided congestive heart failure (RCHF) from non-cardiac (NC) causes of pleural/abdominal effusion. Hypothesis/Objectives – The hepatic pulsed wave Doppler waveform velocities, maximum retrograde velocities, or hepatic vein diameter will be significantly different in patients with RCHF compared to patients with a NC cause of effusion. Animals – Client-owned dogs were divided into two groups of RCHF or NC causes of pleural and/or abdominal effusion. Diagnosis was based on complete echocardiogram, NT-proBNP testing, and additional diagnostics, when available. Methods – Prospective cohort study. Color and pulsed wave spectral Doppler of a hepatic vein with concurrent electrocardiogram were used to assess hepatic waveform velocities, maximum antegrade and retrograde waveform velocities, and hepatic vein diameters. Results – A total of 11 patients in the RCHF group and 5 patients in the NC group were enrolled. RCHF patients had significantly higher maximum retrograde wave velocities (median 0.52 m/s, IQR 0.39 - 0.86 m/s) and normalized hepatic vein diameters (median 3.35, IQR 2.32 - 3.72) compared to NC patients (median 0.20 m/s and 1.22, IQR 0.0 - 0.24 and 1.14 - 1.47, respectively). Conclusions and Clinical Importance – Maximum retrograde hepatic waveform velocity and normalized hepatic vein diameter may be useful in differentiating patients with RCHF from other causes of pleural and abdominal effusion.
