Optimizing diastolic pressure gradient assessment.

ABSTRACT: AIMS:The diastolic pressure gradient (DPG) has been proposed as a marker pulmonary vascular disease in the setting of left heart failure (HF). However, its diagnostic utility is compromised by the high prevalence of physiologically incompatible negative values (DPGNEG) and the contradictory evidence on its prognostic value. Pressure pulsatility impacts on DPG measurements, thus conceivably, pulmonary artery wedge pressure (PAWP) measurements insusceptible to the oscillatory effect of the V-wave might yield a more reliable DPG assessment. We set out to investigate how the instantaneous PAWP at the trough of the Y-descent (PAWPY) influences the prevalence of DPGNEG and the prognostic value of the resultant DPGY. METHODS:Hundred and fifty-three consecutive HF patients referred for right heart catheterisation were enrolled prospectively. DPG, as currently recommended, was calculated. Subsequently, PAWPY was measured and the corresponding DPGY was calculated. RESULTS:DPGY yielded higher values (median, IQR: 3.2, 0.6-5.7 mmHg) than DPG (median, IQR: 0.9,?-?1.7-3.8 mmHg); p?

SUBMITTER: Manouras A 

PROVIDER: S-EPMC7588394 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature