Hepatic Congestion Grading (Echo Doppler based) Calculator
- Hepatic Congestion Grading (Echo Doppler based): Explanation and Clinical Context
Hepatic congestion grading uses Doppler assessment of hepatic vein flow (S wave / D wave ratio) and inferior vena cava (IVC) diameter to quantify venous congestion. The S/D ratio reflects right atrial pressure and hepatic venous compliance, while IVC diameter indicates systemic venous overload.
Grade 0 (no congestion) is indicated by normal S/D ratio (> 1) and IVC < 20 mm, representing normal venous return.
Grade 1 (mild congestion) occurs when S/D ratio is 0.5–1 with IVC < 20 mm, indicating early hepatic venous congestion.
Grade 2 (moderate congestion) is defined by S/D ratio <0.5 with IVC < 20 mm, suggesting significant hepatic congestion with potential right heart dysfunction.
Grade 3 (severe congestion) occurs with dilated IVC >20 mm, reflecting high right atrial pressure and advanced hepatic congestion.
This tool assists clinicians in detecting subclinical congestion, guiding volume management, and monitoring patients with right heart failure or pulmonary hypertension.
Reference:
Kim D, et al. Hepatic Venous Doppler Waveform and Right Heart Failure. JACC Cardiovasc Imaging. 2017;10:1439-1450. doi:10.1016/j.jcmg.2017.04.013
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