Evaluation of Pulmonary Arterial End-Diastolic Pressure as an Estimate of Left Ventricular End-Diastolic Pressure in Patients with Normal and Abnormal Left Ventricular Performance

Abstract

It has been suggested that the pulmonary arterial end-diastolic pressure (EDP) may accurately reflect the level of left ventricular EDP, and therefore be useful in the continuous monitoring of left ventricular EDP in acutely ill patients. Accordingly, pulmonary arterial pressure was recorded simultaneously with left ventricular pressure in 24 patients with normal left ventricular function and in 26 patients with left ventricular myocardial disease and elevated EDP (range 13 to 38 mm Hg; average 22 mm Hg). In patients with normal left ventricular function, the EDPs in the left ventricle and pulmonary artery were equal (range 5 to 12 mm Hg; average 8 mm Hg; maximum difference ± 4 mm Hg). In contrast, in 20 of the patients with impaired left ventricular function, left ventricular EDP was consistently higher than pulmonary arterial EDP, exceeding the pulmonary arterial EDP by 2 to 21 mm Hg (average 8 mm Hg); in 12 of these 20 patients, the pulmonary arterial EDP was 12 mm Hg or less, the upper limit of normal...