Response to ‘Simple jugular venous assessment: a new approach to heart failure’

We thank Dr. Kawasaki for his interest in our paper. We agree that the assessment of jugular venous pressure (JVP) is essential in basic cardiological evaluation and should be performed as a regular clinical assessment.

While it might be a crude method to assess elevated central venous pressures (CVP), its assessment is non-invasive and non-time consuming and provides a lot of information in different clinical settings. In the emergency department, assessment of the jugular vein adds information on the differential diagnosis for patients with arrhythmia, shock and/or dyspnoea.^{1, 2} Furthermore, clinical assessment of jugular venous pressure is essential in guiding diuretic treatment in patients with heart failure as a high JVP indicates persistent elevated RAP and a need for more diuresis, while a normal JVP implies a euvolaemic state.¹ Lastly, heart failure patients with persistent elevated JVP have a higher risk for short-term rehospitalization, possibly due to residual congestion.³ As assessment of the JVP provides a lot of information, basically for free, we believe it is the cardiovascular physician's best friend.

GHDV has nothing to disclose. The employer of AAV received consultancy fees and/or research support from Adrenomed, AnaCardio, AstraZeneca, Bayer AG, BMS, Boehringer Ingelheim, Corteria, Eli Lilly, Merck, Moderna, Novartis, Novo Nordisk, Roche Diagnostics and Salubris Bio. KD reports speaker and consultancy fees from Boehringer Ingelheim, AstraZeneca, Abbott, FIRE1 and Echosense. JMtM reports speaker and/or consultancy fees from Novartis, Bayer, Boehringer Ingelheim, Johnson & Johnson, Moderna, Roche and Novo Nordisk and receives grants from the Dutch Heart Foundation and Netherlands Organisation for Scientific Research (NWO) outside the submitted work.