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

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 r = 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.