The prognostic value of the relationship between right atrial and pulmonary capillary wedge pressure in diverse cardiovascular conditions

American Heart Journal
Douglas Marshall BrinkleyRobb D Kociol

Abstract

Physical examination of jugular venous pressure is used to estimate right atrial (RA) pressure and infer left-sided filling pressure to assist volume management. Previous studies in advanced heart failure patients showed about 75% concordance between RA and pulmonary capillary wedge (PCW) pressures. We sought to determine the relationship between mean RA and mean PCW pressure and assess the clinical significance in a broad population of patients undergoing invasive right heart catheterization (RHC). We examined 4135 RHC cases at a single academic medical center from February 2007 to December 2014, analyzing baseline variables, hemodynamic data, and in-hospital mortality. The overall Pearson correlation for mean RA and PCW pressures was 0.68 with 70% concordance between dichotomized pressures (RA ≥10 and PCW ≥22 mmHg). Results were similar in subgroups with heart failure (r=0.67, 72%), STEMI/NSTEMI (r=0.60, 69%), unstable angina (r=0.78, 69%), stable/no angina (r=0.72, 67%), and valvular disease (r=0.61, 72%; Chi-square P=.15). Mean RA pressure was independently associated with in-hospital mortality in multivariate analysis (OR 1.12 [95% CI 1.081-1.157] per 1 mmHg increase, P<.001). The RA/PCW ratio was not independently associa...Continue Reading

Citations

May 22, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Navin K KapurDaniel Burkhoff
Nov 28, 2019·Journal of Cardiovascular Translational Research·Navin K KapurRichard H Karas
Apr 17, 2020·Circulation. Heart Failure·Hannah RosenblumDaniel Burkhoff
Mar 26, 2021·Frontiers in Cardiovascular Medicine·Matteo TomaPietro Ameri
Dec 28, 2021·Annals of Internal Medicine·Libo WangLillian Khor

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