Evaluation of Central Venous Pressure using Thermal Imaging of the Neck Vein

Background: Central venous pressure is an important determinant of heart failure. Visualization of the jugular distension (JVP) is often utilized but is limited by imprecision. Thermal imaging may be utilized to improve such evaluation.

Methods: We used a novel thermal imaging algorithm for the point of decreased pulsatility in the vessel to evaluate the pressure column above the right atrium. Patients undergoing invasive hemodynamic evaluation were prospectively evaluated for both visual JVP and thermal imaging compared with invasive right atrial pressure (both peak and mean)

Results: Fifteen patients (mean age 60 years 53% males) were included. Four were evaluated for pulmonary hypertension, 2 for myocardial biopsy 1 with LVAD and 8 for heart failure. Thermal image was unsuccessful for 1 patient.

Invasive RA pressure was 10.1±4.2mmHg. Peak RA pressure was 14.3±4.9mmHg. Correlations with mean RA was R²=0.122 for visual evaluation and R²=0.874 for thermal imaging. Correlation with peak RA pressure was R²=0.182 for visual and R²=0.887 for thermal.

Conclusion: While visual evaluation of JVP is impercise, thermal imaging is well correlated to invasive RA pressure. Both visual and thermal jugular evaluation correlate better with peak rather than mean RA pressure.