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Non‐invasive monitoring of pulmonary capillary wedge pressure in heart failure
Author(s) -
Martins Susana,
Soares Rui M.,
Branco Luísa,
Salomão Spencer,
Antunes A. Mata
Publication year - 2001
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(00)00088-x
Subject(s) - medicine , pulmonary wedge pressure , cardiology , heart failure , dilated cardiomyopathy , hemodynamics , sinus rhythm , atrial fibrillation
Objective: To evaluate the usefulness of pulsed Doppler (PD) mitral flow E wave deceleration time (EDcT) to detect and quantify changes of pulmonary capillary wedge pressure (PCWP) in patients (pt) with dilated chronic heart failure (CHF) submitted to tailored therapy. Methods: In 14 pt with dilated cardiomyopathy (DCM) (59.4 ± 10.0 years, 11 males, sinus rhythm), admitted to the ICU because of worsening CHF, serial simultaneous hemodynamic and echocardiographic studies were performed (3–5/pt; overall 49 evaluations). PD mitral flow register was used to measure EDcT and correlated with PCWP at each study. Results: PCWP ranged from 36 to 3 mmHg (17.6 ± 8.8) and EDcT from 271 to 52 ms (104.9 ± 42.4). The correlation between EDcT and PCWP was −0.65 (PCWP = 31.7–0.134EDcT). Using this equation to calculate PCWP, individual absolute values difference (identity error — IE) was 5.6 ± 3.5 mmHg (0.4–14.6). In 29 cases (59.2%) IE was > 5 mmHg, defined as major error. Considering EDcT percent change (Δ%EDcT) and PCWP variation (ΔPCWP) in serial evaluations, we found a correlation of −0.87 (ΔPCWP = −2.83–0.19 Δ%EDcT). Using this equation, the IE was 2.3 ± 1.6 mmHg (0–5.2) and there were only two (6%) major errors ( P < 0.0001). Conclusions: In pt with DCM and advanced CHF, EDcT shows a reasonable correlation with PCWP, but when it is used to calculate PCWP the IE to hemodynamic values is often large. However, our results with EDcT percent change in serial evaluations using a first simultaneous invasive determination, suggest that this technique is reliable for monitoring PCWP and can be particularly useful for pt submitted to tailored therapy.