Reliability of central venous pressure as an indicator of left atrial pressure. A study in patients with mitral valve disease.

Central venous pressure (CVP) measurements have been used extensively in the management of critically ill patients. The value of CVP determinations was studied by determining the relationship of left atrial and right atrial pressares in 200 patients undergoing transsepta1 heart catheterization. All patients had mitral valve disease. The correlation coefficient of left atrial and right atrial pressure was 0.48. Low right atrial pressure (below 3 mm Hg) wss seen &I 18 of 91 patients with left atrial pressure 20 mm H g or greater. In 25 patients, acute pressure changes were induced by volume expansion, pachng, or drug infusion ( h o p terenol or phenylephrine). Increases in left atrial pressure hquently failed to be reflected in right atrial pressure changes. CenW venous pressare may be misleading as a guide to left atrial pressure.