Is Pulmonary Capillary Wedge Pressure a Reliable Indicator of Postcapillary Pulmonary Hypertension?

Although current pulmonary hypertension (PH) guidelines recommend a pulmonary capillary wedge pressure (PCWP) >15 mm Hg for the detection of a postcapillary component, the rationale of this recommendation may not be quite compatible with the peculiar hemodynamics of PH. We hypothesize that a high...

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Bibliographic Details
Published in:The American journal of cardiology 2024-01, Vol.211, p.307-315
Main Authors: Aslanger, Emre, Akaslan, Dursun, Ataş, Halil, Yıldırımtürk, Özlem, Öz, Melih, Kocakaya, Derya, Yıldızeli, Bedrettin, Mutlu, Bülent
Format: Article
Language:English
Subjects:
Accuracy
Angioplasty
Capillary pressure
Cardiac Catheterization
Cardiovascular diseases
Catheters
Classification
Classification schemes
Ejection fraction
Heart diseases
Hemodynamics
Hemodynamics - physiology
Hospitals
Humans
Hypertension
Hypertension, Pulmonary - diagnosis
Kidney diseases
Mortality
Observational studies
Population studies
Pulmonary Wedge Pressure - physiology
Retrospective Studies
Subgroups
Ventricle
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Summary:Although current pulmonary hypertension (PH) guidelines recommend a pulmonary capillary wedge pressure (PCWP) >15 mm Hg for the detection of a postcapillary component, the rationale of this recommendation may not be quite compatible with the peculiar hemodynamics of PH. We hypothesize that a high PCWP alone does not necessarily indicate left-sided disease, and this diagnosis can be improved using left ventricle transmural pressure difference (∆ P ). In this 2-center, retrospective, observational study, we enrolled 1,070 patients with PH who underwent heart catheterization, with the final study population comprising 961 cases. ∆ P was calculated as PCWP minus right atrial pressure. The patients with group II PH had significantly higher ∆ P values (12.6 ± 6.6 mm Hg) compared with the other groups (1.1 ± 4.8 in group I, 12.4 ± 6.6 in group II, 2.5 ± 6.4 in group III, and 0.8 ± 8.0 in group IV, p 15 (area under curve 0.825, 95% confidence interval 0.784 to 0.866, p
ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2023.11.034