Evaluation of Common Clinical and Hemodynamic Parameters to Pulmonary Capillary Wedge Pressures in Patients Undergoing Right Heart Catheterization Clinical and hemodynamic parameters compared to PCWP

Main Article Content

Kyle M. Hocking, PhD Jessica Huston, MD Jeffery Schmeckpeper, MD, PhD Monica Polcz, MD Marisa Case, RN Meghan Breed, MD Lexie Vaughn, MD Dawson Wervey, BS Colleen Brophy, MD JoAnn Lindenfeld, MD Bret D Alvis, MD

Abstract

Introduction: A cornerstone of heart failure assessment is the right heart catheterization and the pulmonary capillary wedge pressure measurement it can provide.  Clinical and hemodynamic parameters such as weight and jugular venous distention are less invasive measures often used to diagnose, manage, and treat these patients. To date, there is little data looking at the association of these key parameters to measured pulmonary capillary wedge pressure (PCWP). This is a large, retrospective, secondary analysis of a right heart catheterization database comparing clinical and hemodynamic parameters against measured PCWP in heart failure patients.


Methods: A total of 538 subjects were included in this secondary analysis. Spearman’s Rho analysis of each clinical and hemodynamic variable was used to compare their association to the documented PCWP. Variables analyzed included weight, body mass index (BMI), jugular venous distention (JVD), creatinine, edema grade, right atrial pressure (RAP), pulmonary artery systolic pressure (PASP), systemic vascular resistance, pulmonary vascular resistance, cardiac output (thermal and Fick), systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, oxygen saturation (SpO2), and pulmonary artery diastolic pressure (PADP).


Results: Ten out of 17 selected parameters had a statistically significant association with measured PCWP values. PADP had the strongest association (0.73, p<0.0001), followed by RAP and PASP (0.69, p<0.0001 and 0.67, p<0.0001, respectively). Other significant parameters included weight (0.2, p<0.001), BMI (0.2, p<0.001), SpO2 (-0.17, p<0.0091), JVD (0.24, p<0.005) and edema grade (0.2, p<0.0001).


Conclusion: This retrospective analysis clarifies the associations of commonly used clinical and hemodynamic parameters to the clinically used gold standard for volume assessment in heart failure patients, PCWP.

Keywords: Congestion, heart failure, right heart catheterization, PCWP

Article Details

How to Cite
HOCKING, Kyle M. et al. Evaluation of Common Clinical and Hemodynamic Parameters to Pulmonary Capillary Wedge Pressures in Patients Undergoing Right Heart Catheterization. Medical Research Archives, [S.l.], v. 10, n. 11, nov. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3276>. Date accessed: 17 june 2024. doi: https://doi.org/10.18103/mra.v10i11.3276.
Section
Research Articles

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