Right and left heart catheterization demonstrated that in the absence of mitral valvular obstruction, pulmonary artery diastolic and left ventricular end-diastolic pressures are identical.
Observational (n=70)
Does a pressure gradient exist between the pulmonary artery and the left ventricle at the end of diastole in patients with congenital or acquired heart disease?
In the absence of mitral obstruction or pulmonary vascular disease, pulmonary artery diastolic pressure accurately reflects left ventricular end-diastolic pressure due to pressure equilibrium across the pulmonary bed.
By means of right and left heart catheterization 70 patients with congenital or acquired heart disease were examined to determine whether or not a gradient in pressure existed between the pulmonary artery and the left ventricle at the end of diastole. In the absence of mitral valvular obstruction in 56 patients there was a statistically significant correlation of pulmonary artery diastolic, left ventricular end-diastolic, and left atrial mean pressures less than 15 mm Hg which was independent of heart rate. Diastolic pressures at identical levels as high as 40 mm Hg were demonstrated in the presence of aortic insufficiency without left ventricular failure, and as high as 47 mm Hg during pulmonary edema in one patient with aortic stenosis and insufficiency. A diastolic gradient in pressure between the pulmonary artery and the left ventricle existed in 14 patients with pulmonary hypertension. These patients all had congenital intracardiac shunts and it may be assumed that they had some obstruction in the pulmonary vascular bed. These findings suggest that within defined limits friction across the pulmonary vascular bed is so small that a state of pressure equilibrium exists at the end of diastole. When the limits are met clinically, the pressures in the pulmonary artery and in the left ventricle at the end of diastole are identical.
Kaltman et al. (Thu,) conducted a observational in Congenital or acquired heart disease (n=70). Right and left heart catheterization was evaluated on Gradient in pressure between the pulmonary artery and the left ventricle at the end of diastole. Right and left heart catheterization demonstrated that in the absence of mitral valvular obstruction, pulmonary artery diastolic and left ventricular end-diastolic pressures are identical.