Inferior vena cava wall thickness is associated with the presence and severity of cardiovascular disease

Abstract

Abstract Background Venous hypertrophy is a pathological condition that is commonly observed as individuals age. However, the clinical index and significance of venous hypertrophy are not yet fully understood. Purpose The purpose of this study was to clarify the relationship between clinical venous hypertrophy and cardiovascular disease (CVD). Methods A total of 407 patients who underwent echocardiography and evaluation of their endothelial function during a medical checkup were included in the study. Clinical venous hypertrophy was evaluated by measuring the thickness of the inferior vena cava wall (IVCWT) using echocardiography. Endothelial function was evaluated using flow-mediated dilation (FMD). CVD included ischemic heart disease, heart failure, and atrial fibrillation. The patients were divided into two groups based on the median value of IVCWT and their clinical characteristics were compared. Results The IVCWT was found to be normally distributed with a median value of 1.25 mm (p < 0.001). The high-IVCWT group was found to be older (62.1 ± 13.1 years versus 58.1 ± 12.0 years, p = 0.001), had a higher ratio of males (72.4% versus 60.3%, p = 0.010), a higher ratio of CVD (7.4% versus 2.7%, p = 0.002), a lower left ventricular ejection fraction (62.1 ± 10.9% versus 64.6 ± 7.6%, p = 0.009), higher levels of B-type natriuretic peptide (21.0 [12.1-48.4] pg/mL versus 14.0 [8.9-33.5] pg/mL, p = 0.039), and lower FMD values (5.36 ± 2.33% versus 5.99 ± 2.73%, p = 0.012) compared to the low-IVCWT group. Multivariate analysis revealed that IVCWT and age were independent factors for the prevalence of CVD (IVCWT: Odds ratio 2.563, 95% confidence interval 1.258-5.563, p = 0.009; age: Odds ratio 1.049, 95% confidence interval 1.021-1.078, p < 0.001). The receiver-operating characteristic analysis found that the best cut-off values for IVCWT and FMD to identify CVD were 1.60 mm and 0.49, respectively (IVCWT: area under the curve 0.731, p < 0.001, sensitivity 51%, specificity 90%; FMD: area under the curve 0.739, p < 0.001, sensitivity 80%, specificity 61%). Conclusion The results of this study suggest that IVCWT is associated not only with age, but also with the presence and severity of CVD.Figure 1Figure 2