https://doi.org/10.4081/vl.2021.9732
Spectral characteristics of the internal jugular vein and central venous pressure pulses: a proof of concept study
Published: 29 March 2021
Abstract Views: 1081
PDF: 366
HTML: 100
HTML: 100
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
In this proof-of-concept study the impact of central venous pressure (CVP) on internal jugular veins cross-sectional area (CSA) and blood flow time-average velocity (TAV) was evaluated in eight subjects, with the aim of understanding the drivers of the jugular venous pulse. CVP was measured using a central venous catheter while CSA variation and TAV along a cardiac cycle were acquired using ultrasound. Analysis of CVP, CSA and TAV time-series signals revealed TAV and CSA to lag behind CVP by on average 0.129 s and 0.138 s, with an inverse correlation between CSA and TAV (r= –0.316). The respective autocorrelation signals were strongly correlated (mean r=0.729-0.764), with mean CSA periodicity being 1.062 Hz. Fourier analysis revealed the frequency spectrums of CVP, TAV and CSA signals to be dominated by frequencies at approximately 1 and 2 Hz, with those >1 Hz greatly attenuated in the CSA signal. Because the autocorrelograms and periodograms of the respective signals were aligned and dominated by the same underlying frequencies, this suggested that they are more easily interpreted in the frequency domain rather than the time domain.
Garg N, Garg N. Jugular venous pulse: an appraisal. J Indian Acad Clin Med 2000;1;261-9.
Chua Chiaco JM, Parikh NI, Fergusson DJ. The jugular venous pressure revisited. Cleve Clin J Med 2013;80:638-44.
DOI: https://doi.org/10.3949/ccjm.80a.13039
Applefeld MM. The jugular venous pressure and pulse contour. In: Walker HK, Hall WD, Hurst, JW, eds. Clinical methods: the history, physical, and laboratory examinations. Boston, MA: Butterworth; 1990. pp 107-111.
Drazner MH, Rame JE, Stevenson LW, Dries DL. Prognostic importance of elevated jugular venous pressure and a third heart sound in patients with heart failure. N Engl J Med 2001;345:574-81.
DOI: https://doi.org/10.1056/NEJMoa010641
Beggs CB, Magnano C, Shepherd SJ, et al. Aqueductal cerebrospinal fluid pulsatility in healthy individuals is affected by impaired cerebral venous outflow. J Magn Reson Imaging 2014;40:1215-22.
DOI: https://doi.org/10.1002/jmri.24468
Hatt A, Cheng S, Tan K, et al. MR elastography can be used to measure brain stiffness changes as a result of altered cranial venous drainage during jugular compression. AJNR Am J Neuroradiol 2015;36:1971-7.
DOI: https://doi.org/10.3174/ajnr.A4361
Lagana MM, Shepherd SJ, Cecconi P, Beggs CB. Intracranial volumetric changes govern cerebrospinal fluid flow in the Aqueduct of Sylvius in healthy adults. Biomed Signal Process Control 2017;36:84-92.
DOI: https://doi.org/10.1016/j.bspc.2017.03.019
Ward KR, Tiba MH, Barbee RW, et al. A new noninvasive method to determine central venous pressure. Resuscitation 2006;70:238-46.
DOI: https://doi.org/10.1016/j.resuscitation.2005.12.013
Brennan JM, Blair JE, Goonewardena S, et al. A comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. Am J Cardiol 2007;99:1614-6.
DOI: https://doi.org/10.1016/j.amjcard.2007.01.037
Sanfilippo F, Noto A, Martucci G, et al. Central venous pressure monitoring via peripherally or centrally inserted central catheters: a systematic review and meta-analysis. J Vasc Access 2017;18:273-8.
DOI: https://doi.org/10.5301/jva.5000749
McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med 2003;348:1123-33.
DOI: https://doi.org/10.1056/NEJMra011883
Sisini F, Tessari M, Gadda G, et al. An ultrasonographic technique to assess the jugular venous pulse: a proof of concept. Ultrasound Med Biol 2015;41:1334-41.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2014.12.666
Sisini F, Tessari M, Menegatti E, et al. Clinical applicability of assessment of jugular flow over the individual cardiac cycle compared with current ultrasound methodology. Ultrasound Med Biol 2016;42:1750-63.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2016.03.002
Hossein-Nejad H, Mohammadinejad P, Ahmadi F. Internal jugular vein/common carotid artery cross-sectional area ratio and central venous pressure. J Clin Ultrasound 2016;44:312-8.
DOI: https://doi.org/10.1002/jcu.22339
Ogum C, Hariharan S, Chen D. Non-invasive central venous pressure estimation by ultrasound guided internal jugular vein cross-sectional area measurement. Biomed Phys Eng Express 2016;2:025004.
DOI: https://doi.org/10.1088/2057-1976/2/2/025004
Bano S, Qadeer A, Akhtar A, et al. Measurement of internal jugular vein and common carotid artery diameter ratio by ultrasound to estimate central venous pressure. Cureus 2018;10:e2277.
DOI: https://doi.org/10.7759/cureus.2277
Zamboni P, Sisini F, Menegatti E, et al. Ultrasound monitoring of jugular venous pulse during space missions: proof of concept. Ultrasound Med Biol 2018;44:726-33.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2017.11.001
Zamboni P, Malagoni AM, Menegatti E, et al. Central venous pressure estimation from ultrasound assessment of the jugular venous pulse. PLoS One 2020;15:e0240057.
DOI: https://doi.org/10.1371/journal.pone.0240057
Smith RN, Nolan JP. Central venous catheters. BMJ 2013;347:f6570.
DOI: https://doi.org/10.1136/bmj.f6570
Tavoni V. Technical note for post processing of jugular venous pulse, central venous pressure and velocity trace. Veins and Lymphatics 2020;9:8268.
DOI: https://doi.org/10.4081/vl.2020.8268
Zamboni P, Menegatti E, Pomidori L, et al. Does thoracic pump influence the cerebral venous return? J Appl Physiol (1985) 2012;112:904-10.
DOI: https://doi.org/10.1152/japplphysiol.00712.2011
Chatfield C. The analysis of time series: an introduction. 4th ed. Boca Raton, FL: Chapman and Hall; 1989.
Welch JP, D’Ambra MN. Hemodynamic monitoring, In: Kofke WA, Levy JH, eds. Postoperative critical care procedures of the Massachusetts General Hospital. Volume 146. Boston, MA: Little, Brown and Company; 1986. pp 146.
Triedman JK, Saul JP. Blood pressure modulation by central venous pressure and respiration. Buffering effects of the heart rate reflexes. Circulation 1994;89:169-79.
DOI: https://doi.org/10.1161/01.CIR.89.1.169
Gelman S. Venous function and central venous pressure: a physiologic story. Anesthesiology. 2008;108:735-48.
DOI: https://doi.org/10.1097/ALN.0b013e3181672607
Batchelor CK, Batchelor GK. An introduction to fluid dynamics. Cambridge: Cambridge University Press; 1967.
Lee CH, Xiao HB, Gibson DG. Jugular venous 'a' wave in dilated cardiomyopathy: sign of abbreviated right ventricular filling time. Br Heart J 1991;65:342-5.
DOI: https://doi.org/10.1136/hrt.65.6.342
Fukuda N, Oki T, Iuchi A, et al. Right heart flow dynamics after tricuspid valve annuloplasty. Characteristics and time course. Jpn Heart J 1998;39:339-46.
DOI: https://doi.org/10.1536/ihj.39.339
Bateman GA, Levi CR, Schofield P, et al. The venous manifestations of pulse wave encephalopathy: windkessel dysfunction in normal aging and senile dementia. Neuroradiology 2008;50:491-7.
DOI: https://doi.org/10.1007/s00234-008-0374-x
Zou R, Park EH, Kelly EM, et al. Intracranial pressure waves: characterization of a pulsation absorber with notch filter properties using systems analysis: laboratory investigation. J Neurosurg Pediatr 2008;2:83-94.
DOI: https://doi.org/10.3171/PED/2008/2/7/083
Zamboni P, Menegatti E, Weinstock-Guttman B, et al. The severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis is related to altered cerebrospinal fluid dynamics. Funct Neurol 2009;24:133-38.
Magnano C, Schirda C, Weinstock-Guttman B, et al. Cine cerebrospinal fluid imaging in multiple sclerosis. J Magn Reson Imaging 2012;36:825-34.
DOI: https://doi.org/10.1002/jmri.23730
Zamboni P, Tavoni V, Sisini F, et al. Venous compliance and clinical implications. Veins and Lymphatics 2018;7:7367.
DOI: https://doi.org/10.4081/vl.2018.7367
Beggs CB. Cerebral venous outflow and cerebrospinal fluid dynamics. Veins and Lymphatics 2014;3:1867.
DOI: https://doi.org/10.4081/vl.2014.1867
How to Cite
Beggs, C., Tavoni, V., Menegatti, E., Tessari, M., Giovanardi, L., Ragazzi, R., & Malagoni, A. M. (2021). Spectral characteristics of the internal jugular vein and central venous pressure pulses: a proof of concept study. Veins and Lymphatics, 10(1). https://doi.org/10.4081/vl.2021.9732
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
