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

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Published Nov 28, 2022
DOI: https://doi.org/10.18103/mra.v10i11.3276

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Kyle M. Hocking, PhD
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
Jessica Huston, MD
Department of Medicine, Division of Cardiovascular Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Jeffery Schmeckpeper, MD, PhD
Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
Monica Polcz, MD
Department of Surgery, Atrium Health, Carolinas Medical Center, Charlotte, NC, USA
Marisa Case, RN
Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
Meghan Breed, MD
Department of Emergency Medicine, TriStar Skyline Medical Center, Nashville, TN, USA
Lexie Vaughn, MD
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
Dawson Wervey, BS
Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
Colleen Brophy, MD
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
JoAnn Lindenfeld, MD
Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
Bret D Alvis, MD
Department of Surgery, Atrium Health, Carolinas Medical Center, Charlotte, NC, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA

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: 19 apr. 2024. doi: https://doi.org/10.18103/mra.v10i11.3276.
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Issue
Vol 10 No 11 (2023): NOVEMBER ISSUE, VOl. 10 ISsue 11
Section
Research Articles

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