Echocardiographic Right Heart Findings in Patients with High-Grade Varicocele

Abstract

Most varicose veins at the infra-abdominal levels are due to primary causes. However, approximately 5-20% of patients experience these secondary to other pathologies such as right heart diastolic dysfunction. Due to the infra-abdominal location of the varicocele, cardiac and vascular secondary pathologies may be observed in patients with varicocele, and this may be expected to lead to abnormal findings on echocardiography. For this purpose, in this study, we aimed to compare some echocardiographic parameters of right heart origin in healthy individuals and high-grade varicocele patients. This study was conducted prospectively and multidisciplinary. Male patients between the ages of 18-50 with only high-grade and left varicocele were included in the 'patient' group. The control group consisted of healthy, volunteer men between the ages of 18-50 who did not have any known diseases. All participants underwent echocardiography at the Cardiology clinic. In echocardiography; right atrium and ventricle diameters, tricuspid regurgitation, ejection fraction (EF), hepatic vein, inferior vena cava (IVC), portal vein, inferior abdominal artery diameters, and pulmonary artery pressure (PAP) values were measured. Age, body mass index (BMI), smoking status and echocardiographic data of all participants were recorded. After exclusion criteria, the study was completed with a total of 259 people. 104 of them are varicocele patient; 155 of them constitute the control group. In the investigation, it was observed that BMI, EF, PAP, hepatic vein diameter, IVC diameter, portal vein diameter, inferior abdominal artery diameter and smoking status were significantly higher in the patient group. On the other hand, age was found to be significantly higher in the control group. This study showed that symptomatic high-grade varicocele patients have a higher risk of cardiovascular and hemodynamic disease than the normal population. Therefore, in the light of our results, we recommend that men with high-grade symptomatic varicocele undergo cardiovascular and hemodynamic evaluation with cardiology consultation.