2026-10-13T21:53:12Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33994087 2026-09-25T08:45:50Z category_7 portal_147 item_type_3 month_year_09_2026

Supplemental Material for: Individual Venous Doppler Abnormalities and Clinical Outcomes in Acute Heart Failure: Insights Beyond the Global VExUS Score figshare admin karger (2628495) José García Cantos (25108434) Paula Isabel Carmona (25108436) Raquel López-Vilella (10191092) María Jesús Montero Hernández (25108437) Miguel Angel Rodenas (25108440) María Victoria Johannenssen López (25108442) Sergi Tormo (25108444) Víctor Donoso Trenado (25108449) Julia Martinez-Solé (25108452) Borja Guerrero Cervera (25108453) Maria Peris-Fernandez (25108462) Amparo Soldevila (25108465) Ramón Devesa (25108468) Pilar Sánchez-Pérez (25108471) Maria Casanova Aparicio (25108473) Luis Almenar-Bonet (25108476) Medicine Medicine <p dir="ltr">Introduction: Systemic venous congestion contributes to organ dysfunction and adverse outcomes in acute heart failure (AHF). The Venous Excess Ultrasound Score (VExUS) evaluates venous congestion, but its prognostic role and the relative contribution of its individual components in ward-admitted patients remains uncertain. We aimed to evaluate the association between global and individual VExUS-derived Doppler findings and clinical outcomes and to explore descriptive congestion patterns using unsupervised clustering. </p><p dir="ltr">Methods: In this prospective observational study, 100 patients admitted with AHF were screened, and 80 with adequate ultrasound windows underwent standardized VExUS assessment within 24 hours of admission. Associations with 6-month all-cause mortality, readmissions, and renal deterioration were evaluated using multiplicity-adjusted statistical models. Hierarchical clustering was performed as an exploratory secondary analysis to characterize underlying profiles. </p><p dir="ltr">Results: Individual VExUS components were significantly associated with mortality: hepatic venous flow abnormalities (OR 5.45, 95% CI 1.01–29.40; p=0.04), increased portal vein pulsatility (OR 26.1, 95% CI 1.74–389.59; p=0.01), and abnormal intrarenal venous flow (OR 6.0, 95% CI 1.01–35.62; p=0.049). Conversely, the aggregate global VExUS grade was not independently associated with mortality or other clinical outcomes. All multivariable models included a single doppler predictor adjusted for discharge creatinine. Exploratory hierarchical clustering delineated two descriptive groups with differing patterns of systemic congestion, renal function, and clinical presentation. The group with more severe systemic congestion exhibited lower estimated glomerular filtration rates and a higher proportion of observed deaths (71.4% vs 28.6% of total events; p=0.029). </p><p dir="ltr">Conclusion: In this single-center cohort, selected individual venous Doppler abnormalities, rather than the aggregate VExUS grade, showed statistically significant associations with adverse outcomes; however, these associations were derived from models with very few events per variable and therefore should be regarded as hypothesis-generating rather than confirmatory. Exploratory clustering suggested the existence of distinct congestion patterns based on VExUS grade and clinical pattern. Larger multicenter studies with adequate event numbers are warranted to validate these exploratory findings and to determine whether they can meaningfully guide decongestive therapy. </p> 2026-09-25T08:45:50Z Dataset Dataset 10.6084/m9.figshare.33994087.v1 https://figshare.com/articles/dataset/Supplemental_Material_for_Individual_Venous_Doppler_Abnormalities_and_Clinical_Outcomes_in_Acute_Heart_Failure_Insights_Beyond_the_Global_VExUS_Score/33994087 CC BY 4.0