VExUS correlates strongly with right atrium pressure and outperforms traditional markers in predicting elevated filling pressures and acute kidney injury in CHF and CRS patients.
Does the VExUS score improve volume status assessment and prediction of acute kidney injury in patients with acute decompensated heart failure and cardiorenal syndrome compared to traditional approaches?
The VExUS score is a promising noninvasive tool that integrates multiple Doppler assessments to accurately evaluate systemic congestion and predict acute kidney injury in patients with heart failure and cardiorenal syndrome.
Absolute Event Rate: 0% vs 0%
Accurate assessment of volume status and venous congestion is essential in the management of congestive heart failure (CHF), particularly in patients with cardiorenal syndrome (CRS). Traditional approaches, including physical examination, laboratory biomarkers, and noninvasive hemodynamic monitoring, have notable limitations in reliably detecting venous congestion. The Venous Excess Ultrasound (VExUS) score, introduced in 2020, offers a noninvasive and widely available method to evaluate systemic congestion by integrating Doppler assessment of the inferior vena cava, hepatic, portal, and intrarenal veins. This narrative review summarizes the current evidence supporting the utility of VExUS in CHF and CRS, highlighting its diagnostic performance, advantages, and challenges. Studies demonstrate that VExUS correlates strongly with right atrium pressure and outperforms individual ultrasound or biochemical markers in predicting elevated filling pressures and acute kidney injury. Its application may help detect subclinical renal congestion and guide diuretic therapy before irreversible renal injury occurs. Despite these strengths, the technique has limitations, including technical complexity, operator dependence, and potential inaccuracy in the presence of liver disease or significant tricuspid regurgitation. Overall, VExUS represents a promising and widely accessible tool that enhances risk stratification and treatment optimization in CHF and CRS. Further prospective studies are needed to standardize image acquisition, validate its prognostic value across diverse populations, and define its role within heart failure management algorithms and diuretic-guided therapy protocols.
Soliman et al. (Thu,) reported a other. VExUS correlates strongly with right atrium pressure and outperforms traditional markers in predicting elevated filling pressures and acute kidney injury in CHF and CRS patients.