Relationship of Pulmonary Artery to Left Ventricular Diastolic Pressures in Acute Myocardial Infarction
作者:
Shahbudin Rahimtoola,
Henry Loeb,
Ali Ehsani,
M. Sinno,
Ruben Chuquimia,
Roshan Lal,
Kenneth Rosen,
Rolf Gunnar,
期刊:
Circulation
(OVID Available online 1972)
卷期:
Volume 46,
issue 2
页码: 283-290
ISSN:0009-7322
年代: 1972
出版商: OVID
关键词: Left ventricular end-diastolic pressure;Pulmonary artery diastolic pressure;Left ventricular diastolic pressure pre-a wave;Pulmonary edema;Left ventricular performance;Left atrial pressure;Pulmonary artery wedge pressure
数据来源: OVID
摘要:
We have measured pulmonary artery (PA) and left ventricular diastolic pressures (LVDP) in patients with acute myocardial infarction to establish the relationships of PA pressure to LVDP. Paired determinations for the various parameters showed (mean difference in mm Hg): left ventricular end-diastolic pressure (LVEDP)-LVDP pre-a + 7.9,P< 0.001; LVEDP-mean PA wedge + 6.0,P< 0.001; mean PA wedge-LVDP pre-a, + 0.8,P> 0.2; PA end-diastolic pressure (PAEDP)-mean PA wedge (in all patients) +3.3,P< 0.001; PAEDP-mean PA wedge (patients with pulmonary vascular resistance ≦2 units) +1.3,P< 0.1; LVEDP-PAEDP +4.7,P< 0.001; and LVEDP-mean PA −2.0,P< 0.02. The relationship of LVEDP to mean PA wedge was: LVEDP (y) = 1.12 mean PA wedge (x) +4.69; Sy.x = 3.42; r = 0.92.After acute myocardial infarction, PA pressures did not accurately reflect LVEDP because atrial contraction made a large contribution to ventricular filling pressure. In addition, PAEDPs were not the same as mean PA wedge pressures because of some increase of pulmonary vascular resistance in many patients. Thus, PA pressures only provided reliable information about the level of pulmonary venous pressure. LVDP pre-a correlated well with mean PA wedge pressure, and therefore measurement of LVDP (pre-a and EDP) yielded information not only about pulmonary edema, but also about LV performance.
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