CHARACTERISTICS OF VENOUS CONGESTION AS ASSESSED BY THE VEXUS SCORE IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE
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Abstract
Objective: To describe the characteristics of venous congestion assessed by the VExUS score and to analyze the associations between the VExUS score and selected clinical and laboratory characteristics in patients with acute decompensated heart failure treated at Thai Nguyen National Hospital.
Methods: A prospective cross-sectional descriptive study was conducted in 70 patients with acute decompensated heart failure treated at Thai Nguyen National Hospital from August 2025 to August 2026.
Results: The median age was 74 years, and females accounted for 55.7% of the study population. Clinical manifestations included orthopnea in 90%, peripheral edema in 50%, and pulmonary crackles in 55.7%; 64.3% of patients were classified as NYHA functional class III–IV. The median NT-proBNP level was 5,089.17 pg/mL, the mean eGFR was 52.41 ± 22.53 mL/min/1.73 m², and 52.9% of patients had an EF ≤40%. An IVC diameter ≥2 cm was observed in 71.4% of patients, while VExUS grade 2–3 accounted for 48.6%. Compared with patients with VExUS grade 0–1, those with grade 2–3 had higher proportions of NYHA III–IV and peripheral edema, higher NT-proBNP levels (15,145.58 vs. 2,041.50 pg/mL), and longer hospital stays (12.59 vs. 8.44 days) (p<0.05). No significant associations were observed between VExUS grade and EF, mortality, ICU admission, intravenous diuretic use, or vasopressor use (p>0.05). NT-proBNP was positively correlated with the severity of hepatic, portal, and renal venous Doppler abnormalities (p<0.05).
Conclusion: Venous congestion is common in patients with acute decompensated heart failure. VExUS grade 2–3 is associated with greater heart failure severity, higher NT-proBNP levels, and longer hospital stays. VExUS may be a useful point-of-care ultrasound tool for identifying and grading venous congestion in patients with acute decompensated heart failure.
Keywords
Acute decompensated heart failure, venous congestion, VExUS, NT-proBNP, point-of-care ultrasound
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References
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