Your browser doesn't support javascript.
loading
Improved Interpretation of Pulmonary Artery Wedge Pressures through Left Atrial Volumetry-A Cardiac Magnetic Resonance Imaging Study.
Güder, Gülmisal; Reiter, Theresa; Drayss, Maria; Bauer, Wolfgang; Lengenfelder, Björn; Nordbeck, Peter; Fette, Georg; Frantz, Stefan; Morbach, Caroline; Störk, Stefan.
Afiliación
  • Güder G; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Reiter T; Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, 97078 Würzburg, Germany.
  • Drayss M; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Bauer W; Department of Cardiac Rhythm Disorders, German Heart Center Munich, 80636 Munich, Germany.
  • Lengenfelder B; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Nordbeck P; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Fette G; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Frantz S; Division of Cardiology, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany.
  • Morbach C; Department of Clinical Research & Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, 97078 Würzburg, Germany.
  • Störk S; Service Center Medical Informatics (SMI), University of Würzburg, 97080 Würzburg, Germany.
J Cardiovasc Dev Dis ; 11(6)2024 Jun 11.
Article en En | MEDLINE | ID: mdl-38921678
ABSTRACT

BACKGROUND:

The pulmonary artery wedge pressure (PAWP) is regarded as a reliable indicator of left ventricular end-diastolic pressure (LVEDP), but this association is weaker in patients with left-sided heart disease (LHD). We compared morphological differences in cardiac magnetic resonance imaging (CMR) in patients with heart failure (HF) and a reduced left ventricular ejection fraction (LVEF), with or without elevation of PAWP or LVEDP.

METHODS:

We retrospectively identified 121 patients with LVEF < 50% who had undergone right heart catheterization (RHC) and CMR. LVEDP data were available for 75 patients.

RESULTS:

The mean age of the study sample was 63 ± 14 years, the mean LVEF was 32 ± 10%, and 72% were men. About 53% of the patients had an elevated PAWP (>15 mmHg). In multivariable logistic regression analysis, NT-proBNP, left atrial ejection fraction (LAEF), and LV end-systolic volume index independently predicted an elevated PAWP. Of the 75 patients with available LVEDP data, 79% had an elevated LVEDP, and 70% had concomitant PAWP elevation. By contrast, all but one patient with elevated PAWP and half of the patients with normal PAWP had concomitant LVEDP elevation. The Bland-Altman plot revealed a systematic bias of +5.0 mmHg between LVEDP and PAWP. Notably, LAEF was the only CMR variable that differed significantly between patients with elevated LVEDP and a PAWP ≤ or >15 mmHg.

CONCLUSIONS:

In patients with LVEF < 50%, a normal PAWP did not reliably exclude LHD, and an elevated LVEDP was more frequent than an elevated PAWP. LAEF was the most relevant determinant of an increased PAWP, suggesting that a preserved LAEF in LHD may protect against backward failure into the lungs and the subsequent increase in pulmonary pressure.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Cardiovasc Dev Dis Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Cardiovasc Dev Dis Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza