Key result
During exercise cardiac catheterization, end-expiratory PAWP exceeded the 25 mm Hg threshold more frequently than respiratory-averaged PAWP (70% vs 53%, P<0.01), leading to discordant HFpEF diagnoses.
Why the study?
Respiratory pressure swings may cause HFpEF misdiagnosis and threshold values for abnormal exercise hemodynamic response are not universally accepted.
How do respiratory pressure swings and different hemodynamic criteria impact the diagnosis of HFpEF during exercise cardiac catheterization in patients with unexplained dyspnea?
Observational (n=57)
How do respiratory pressure swings and different hemodynamic criteria impact the diagnosis of HFpEF during exercise cardiac catheterization in patients with unexplained dyspnea?
Absolute Event Rate: 70% vs 53%
p-value: p=<0.01
Respiratory pressure swings significantly impact exercise hemodynamic definitions of HFpEF, leading to discordant results in 30% of patients, suggesting that the PAWP exp/cardiac output slope may be the most sensitive and inclusive criterion.
No takes yet. Share an insight, caveat, or question.
End-expiratory PAWP may inflate exercise HFpEF diagnoses versus averaged measures; leaves open optimal standardization for cath protocols.
Baratto et al. (2021) conducted an observational in Unexplained dyspnea (n=57). End-expiratory pulmonary artery wedge pressure (PAWP exp) vs. Respiratory-averaged PAWP (PAWP avg) was evaluated on Proportion of patients exceeding the threshold of 25 mm Hg during exercise (p=<0.01). During exercise cardiac catheterization, end-expiratory PAWP exceeded the 25 mm Hg threshold more frequently than respiratory-averaged PAWP (70% vs 53%, P<0.01), leading to discordant HFpEF diagnoses.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: