Pulmonary artery wedge pressure and left ventricular end-diastolic pressure during exercise in patients with dyspnoea

FIGURE 1. Accuracy and precision of end-expiratory PAWPED and PAWPM estimates for LVEDP, as well as the rate of agreement of PAWP and LVEDP for the diagnosis of HFpEF at rest and during exercise in our population. The pre-test probability of HFpEF in our cohort was intermediate–high based on the H2FPEF score. Exemplificative pressure trace recordings (LV pressure, red; PAWP, blue) are shown both at rest and during exercise. Linear regression analysis and Bland–Altman plot of end-expiratory LVEDP versus PAWP values are shown both at rest and at peak exercise. Both for rest and peak exercise, a and b) PAWP values are reported both at end-diastole (i.e. mid-A wave for patients in sinus rhythm; mid-C or pre-V wave for patients in atrial fibrillation) and c and d) averaged over the cardiac cycle (mean PAWP). Venn diagrams show the agreement of dichotomised PAWP and LVEDP values above the diagnostic threshold to diagnose HFpEF, both at rest and at peak exercise. Agreement between PAWP and LVEDP was higher during exercise than at rest. Despite substantial agreement at peak exercise, five individuals had either PAWP or LVEDP above the diagnostic threshold for HFpEF. All of them presented with a…

FIGURE 2. Linear regression analysis and Bland–Altman plot of respiratory-averaged LVEDP versus PAWP values at rest. Bland-Altman plot and linear regression analysis between end-diastolic PAWP (measured at mid-A in sinus rhythm, at mid-C or pre-V in atrial fibrillation) and LVEDP are shown in panels a) and b). Bland–Altman plot and linear regression analysis between mean PAWP (PAWP averaged over the cardiac cycle) and LVEDP are shown in panels c) and d). LVEDP: left ventricular end-diastolic pressure; PAWPED: end-diastolic pulmonary artery wedge pressure; PAWPM: mean pulmonary artery wedge pressure.

FIGURE 3. Linear regression analysis and Bland–Altman plot of respiratory-averaged LVEDP versus PAWP values at peak exercise. Bland–Altman plot and linear regression analysis between end-diastolic PAWP (measured at mid-A in sinus rhythm, at mid-C or pre-V in atrial fibrillation) and LVEDP are shown in panels a) and b). Bland–Altman plot and linear regression analysis between mean PAWP (PAWP averaged over the cardiac cycle) and LVEDP are shown in panels c) and d). LVEDP: left ventricular end-diastolic pressure; PAWPED: end-diastolic pulmonary artery wedge pressure; PAWPM: mean pulmonary artery wedge pressure.