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Abdominojugular test
The abdominojugular test (AJR), also known as hepatojugular reflux, is a test for measuring jugular venous pressure (JVP) through the distension or swelling of the internal jugular vein. A positive AJR test correlates with the pulmonary artery pressure and thus is a marker for right heart dysfunction, specifically right ventricular failure.〔(The abdominojugular reflux sign. ), Wiese, J. Am J Med. 2000 Jul;109(1):59-61.〕
==Procedure==
The clinician presses firmly over either the right upper quadrant of the abdomen (i.e., over the liver) or over the center of the abdomen 〔 for 10 seconds with a pressure of 20 to 35 mm Hg while observing the internal jugular vein in the neck and also observing to be sure the patient does not perform a Valsalva maneuver.
On an otherwise healthy individual, the jugular venous pressure remains constant or temporarily rises for a heartbeat or two, before returning to normal. This ''negative result'' would be indicated by a lack of swelling of the jugular vein. Negative hepatojugular reflux is seen in Budd-Chiari syndrome.
A ''positive result'' is variously defined as either a sustained rise in the JVP of at least 4 cm or more 〔 or a fall of 4 cm or more 〔 after the examiner releases pressure. The AJR has a reported sensitivity of 24% to 72% 〔 and a specificity of 93% to 96%. The large discrepancy in sensitivity may be explained by the higher value being reported during performance in optimal conditions of a cardiac lab while the lower value was from a study in an emergency room.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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