Quantitative Doppler ultrasound criteria for identifying central venous hypertension in patients with chronic venous disease

Introduction: This study aims to determine whether quantitative Doppler waveform parameters—specifically waveform frequency and acceleration time—are associated with central venous hypertension (CVH) and can be used to identify CVH noninvasively during routine venous duplex ultrasound. Methods: This retrospective case–control study included 199 patients who underwent venous duplex ultrasound. Cases ( n = 63) had a clinical diagnosis of CVH, and age- and sex-matched controls ( n = 136) had no evidence of CVH. Doppler waveforms from the common femoral vein (CFV) and femoral vein (FV) were analyzed for frequency, peak systolic velocity, acceleration time, and volume flow rate. Multivariable regression and receiver operating characteristic analyses were used to assess diagnostic performance. Results: Patients with CVH had significantly higher waveform frequency and shorter acceleration time compared to controls (all p < 0.001). Receiver operating characteristic analysis showed that FV waveform frequency ⩾ 60 cycles/minute had excellent diagnostic accuracy for CVH (AUC = 0.95), and CFV acceleration time < 400 ms was moderately predictive (AUC = 0.67). The combination of FV frequency ⩾ 60 cycles/minute and CFV acceleration time < 400 ms yielded the highest diagnostic performance. Peak systolic velocity and volume flow rate were not associated with CVH. Conclusions: Quantitative spectral Doppler criteria—specifically, increased FV waveform frequency and decreased CFV acceleration time—are strongly associated with CVH. These objective, reproducible parameters may enhance the diagnostic value of routine venous duplex ultrasound and support earlier recognition of occult cardiovascular disease in patients evaluated for chronic venous symptoms.