Significant deviation between reported wedge pressure and diastolic pulmonary arterial pressure found during right heart catheterization in patients undergoing cardiac transplant evaluation.

Abstract

Objectives: Diastolic pulmonary arterial pressure should be the same as wedge pressure in patients with cardiomyopathy without a known history of pulmonary vein occlusive disease. The goal of this study was to study the correlation between reported wedge pressure and pulmonary arterial diastolic pressure in patients with end-stage cardiomyopathy to evaluate the accuracy of right heart pressure reporting.

Methods: Pre-cardiac transplant patients who underwent cardiac catheterization before their heart transplantation at our institution between 2003 and 2005 (n = 159) were retrospectively reviewed. Reported diastolic pulmonary arterial pressure was correlated with reported wedge pressure.

Results: The correlation between reported diastolic pulmonary arterial pressure with wedge pressure was modest with r² = 0.75. There was wide variation with some division up to 40 mmHg. Most discrepancies occurred in the lower and higher-pressure measurements.

Conclusions: Among patients referred for heart transplant evaluation, a correlation between reported diastolic pulmonary pressure and wedge pressure is only modest suggesting a significant error in the reporting or measuring right-sided pressures during right heart catheterization warranting further investigation to reduce errors.