BACKGROUND: Although right-sided filling pressures often mirror left-sided filling pressures in systolic heart failure, it is not known whether a similar relationship exists in heart failure with preserved ejection fraction. METHODS AND RESULTS: Eleven subjects with heart failure with preserved ejection fraction underwent right heart catheterization at rest and under loading conditions manipulated by lower body negative pressure and saline infusion. Right atrial pressure (RAP) was classified as elevated when >or=10 mm Hg and pulmonary capillary wedge pressure (PCWP) when >or=22 mm Hg. If both the RAP and the PCWP were elevated or both not elevated, they were classified as concordant; otherwise, they were classified as discordant. Correlation of RAP and PCWP was determined by a repeated measures model. Among 66 paired measurements of RAP and PCWP, 44 (67%) had a low RAP and PCWP and 8 (12%) a high RAP and PCWP, yielding a concordance rate of 79%. In a sensitivity analysis performed by varying the definition of elevated RAP (from 8 to 12 mm Hg) and PCWP (from 15 to 25 mm Hg), the mean+/-SD concordance of RAP and PCWP was 76+/-10%. The correlation coefficient of RAP and PCWP for the overall cohort was r=0.86 (P<0.0001). CONCLUSIONS: Right-sided filling pressures often reflect left-sided filling pressures in heart failure with preserved ejection fraction, supporting the role of estimation of jugular venous pressure to assess volume status in this condition.
BACKGROUND: Although right-sided filling pressures often mirror left-sided filling pressures in systolic heart failure, it is not known whether a similar relationship exists in heart failure with preserved ejection fraction. METHODS AND RESULTS: Eleven subjects with heart failure with preserved ejection fraction underwent right heart catheterization at rest and under loading conditions manipulated by lower body negative pressure and saline infusion. Right atrial pressure (RAP) was classified as elevated when >or=10 mm Hg and pulmonary capillary wedge pressure (PCWP) when >or=22 mm Hg. If both the RAP and the PCWP were elevated or both not elevated, they were classified as concordant; otherwise, they were classified as discordant. Correlation of RAP and PCWP was determined by a repeated measures model. Among 66 paired measurements of RAP and PCWP, 44 (67%) had a low RAP and PCWP and 8 (12%) a high RAP and PCWP, yielding a concordance rate of 79%. In a sensitivity analysis performed by varying the definition of elevated RAP (from 8 to 12 mm Hg) and PCWP (from 15 to 25 mm Hg), the mean+/-SD concordance of RAP and PCWP was 76+/-10%. The correlation coefficient of RAP and PCWP for the overall cohort was r=0.86 (P<0.0001). CONCLUSIONS: Right-sided filling pressures often reflect left-sided filling pressures in heart failure with preserved ejection fraction, supporting the role of estimation of jugular venous pressure to assess volume status in this condition.
Authors: M H Drazner; M A Hamilton; G Fonarow; J Creaser; C Flavell; L W Stevenson Journal: J Heart Lung Transplant Date: 1999-11 Impact factor: 10.247
Authors: C V Leier; J B Young; T B Levine; I Pina; P W Armstrong; M B Fowler; L Warner-Stevenson; J N Cohn; J B O'Connell; M R Bristow; J M Nicklas; D E Johnstone; J Howlett; H O Ventura; T D Giles; B H Greenberg; K Chatterjee; R C Bourge; C W Yancy; S S Gottleib Journal: Congest Heart Fail Date: 2001 Nov-Dec
Authors: Mark H Drazner; Anne S Hellkamp; Carl V Leier; Monica R Shah; Leslie W Miller; Stuart D Russell; James B Young; Robert M Califf; Anju Nohria Journal: Circ Heart Fail Date: 2008-09 Impact factor: 8.790
Authors: Anand Prasad; Zoran B Popovic; Armin Arbab-Zadeh; Qi Fu; Dean Palmer; Erika Dijk; Neil L Greenberg; Mario J Garcia; James D Thomas; Benjamin D Levine Journal: Am J Cardiol Date: 2007-04-27 Impact factor: 2.778
Authors: J C Buckey; F A Gaffney; L D Lane; B D Levine; D E Watenpaugh; S J Wright; C W Yancy; D M Meyer; C G Blomqvist Journal: J Appl Physiol (1985) Date: 1996-07
Authors: Anand Prasad; Jeffrey L Hastings; Shigeki Shibata; Zoran B Popovic; Armin Arbab-Zadeh; Paul S Bhella; Kazunobu Okazaki; Qi Fu; Martin Berk; Dean Palmer; Neil L Greenberg; Mario J Garcia; James D Thomas; Benjamin D Levine Journal: Circ Heart Fail Date: 2010-08-03 Impact factor: 8.790
Authors: Armin Arbab-Zadeh; Erika Dijk; Anand Prasad; Qi Fu; Pilar Torres; Rong Zhang; James D Thomas; Dean Palmer; Benjamin D Levine Journal: Circulation Date: 2004-09-13 Impact factor: 29.690
Authors: Jerry M John; Mark Haykowsky; Peter Brubaker; Kathy Stewart; Dalane W Kitzman Journal: Am J Physiol Heart Circ Physiol Date: 2010-06-18 Impact factor: 4.733
Authors: Justin L Grodin; Mark H Drazner; Matthias Dupont; Wilfried Mullens; David O Taylor; Randall C Starling; W H Wilson Tang Journal: Am Heart J Date: 2015-02-28 Impact factor: 4.749
Authors: Paul S Bhella; Eric L Pacini; Anand Prasad; Jeffrey L Hastings; Beverley Adams-Huet; James D Thomas; Paul A Grayburn; Benjamin D Levine Journal: Circ Cardiovasc Imaging Date: 2011-07-25 Impact factor: 7.792