Unreliability of Hemodynamic Indexes of Left Ventricular Size during Cardiac Surgery
Key result
Hemodynamic preload indexes correlate poorly with echocardiographic LV cavity area during cardiac surgery.
- r = 0.34
- P<0.03
- n=45
Why the study?
Hemodynamic indexes such as PADP, PAWP, and LVEDP are commonly used to estimate LV preload, but their reliability to reflect anatomical LV volume during cardiac surgery is uncertain.
Do hemodynamic indexes of preload (PADP, PAWP, LVEDP) accurately estimate anatomical preload (LV volume) during cardiac surgery?
Population
45 patients undergoing coronary or aortic valve surgery
Design
Observational study
Authors
Discussion
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Implication
Hemodynamic preload indexes should not guide intraoperative LV volume assessment; supports validation against imaging in future perioperative studies.
Study Design
Type
Observational (n=45)
Structured PICO
Do hemodynamic indexes of preload (PADP, PAWP, LVEDP) accurately estimate anatomical preload (LV volume) during cardiac surgery?
P
Population
45 patients undergoing a coronary or aortic valve procedure.
E
Exposure
Simultaneous measurement of epicardial two-dimensional echocardiographic LV cavity area and hemodynamic indexes (PADP, PAWP, high-fidelity LVEDP)
O
Outcome
Correlation between hemodynamic indexes of preload (PADP, PAWP, LVEDP) and anatomical preload (LV cavity area)surrogate
Main Result
Effect estimate: r = 0.34
p-value: p=<0.03
Hemodynamic indexes of preload (PADP, PAWP) are poor guides to LVEDP and do not reliably reflect changes in LV size during cardiac surgery.
Cite This Study
Douglas et al. (1987) conducted an observational in Patients undergoing coronary or aortic valve procedure (n=45). Hemodynamic indexes of preload (PADP, PAWP, LVEDP) vs. Epicardial two-dimensional echocardiographic LV cavity area was evaluated on Correlation between hemodynamic indexes and LV cavity area (r = 0.34, p=<0.03). Hemodynamic indexes of preload correlated poorly with echocardiographic left ventricular cavity area during cardiac surgery (r=0.34, p<0.03 for PADP; no correlation for PAWP or LVEDP).