In patients with acute myocardial infarction, left ventricular end-diastolic pressure correlated with mean pulmonary artery wedge pressure (r=0.92), but PA pressures did not accurately reflect LVEDP.
Observational
Do pulmonary artery pressures accurately reflect left ventricular diastolic pressures in patients with acute myocardial infarction?
In acute myocardial infarction, pulmonary artery pressures do not accurately reflect left ventricular end-diastolic pressure due to the contribution of atrial contraction and increased pulmonary vascular resistance.
Effect estimate: r = 0.92
We have measured pulmonary artery (PA) and left ventricular diastolic pressures (LVDP) in patients with acute myocardial infarction to establish the relationships of PA pressure to LVDP. Paired determinations for the various parameters showed (mean difference in mm Hg): left ventricular end-diastolic pressure (LVEDP)-LVDP pre-a + 7.9, P 0.2; PA end-diastolic pressure (PAEDP)-mean PA wedge (in all patients) +3.3, P < 0.001; PAEDP-mean PA wedge (patients with pulmonary vascular resistance ≦2 units) +1.3, P < 0.1; LVEDP-PAEDP +4.7, P < 0.001; and LVEDP-mean PA –2.0, P < 0.02. The relationship of LVEDP to mean PA wedge was: LVEDP (y) = 1.12 mean PA wedge (x) +4.69; Sy.x = 3.42; r = 0.92. After acute myocardial infarction, PA pressures did not accurately reflect LVEDP because atrial contraction made a large contribution to ventricular filling pressure. In addition, PAEDPs were not the same as mean PA wedge pressures because of some increase of pulmonary vascular resistance in many patients. Thus, PA pressures only provided reliable information about the level of pulmonary venous pressure. LVDP pre-a correlated well with mean PA wedge pressure, and therefore measurement of LVDP (pre-a and EDP) yielded information not only about pulmonary edema, but also about LV performance.
Rahimtoola et al. (Tue,) conducted a observational in Acute myocardial infarction. Measurement of pulmonary artery and left ventricular diastolic pressures was evaluated on Relationship of pulmonary artery to left ventricular diastolic pressures (r = 0.92). In patients with acute myocardial infarction, left ventricular end-diastolic pressure correlated with mean pulmonary artery wedge pressure (r=0.92), but PA pressures did not accurately reflect LVEDP.