OBJECTIVE Conventional hemodynamic indexes (cardiac index (CI), and pulmonary capillary wedge pressure) are of limited value in the diagnosis and treatment of patients with acute congestive heart failure (CHF). PATIENTS AND METHODS We measured CI, wedge pressure, right atrial pressure (RAP) and mean arterial blood pressure (MAP) in 89 consecutive patients admitted due to acute CHF (exacerbate...

The wedge and left atrial pressures were compared in 1'2 subjects with congenital and aequired heart disease; all experiments were carried out with closed chest under basal conditions. A poor correlation between the wedge and left atrial pressures was mnoted in over half the patients. The wedge pressure is especially inaccurate in mitral stenosis with marked elevations in left atrial pressure.

Pulmonary hypertension complicating left heart disease (PH-LHD) is associated with increased morbidity and mortality, especially in patients who develop combined pre- and post-capillary PH (Cpc-PH). Mechanisms underlying PH-LHD are incompletely understood, particularly for individuals with preserved left ventricular ejection fraction (LVEF). We hypothesized that transpulmonary concentrations of...

Results Tolvaptan at all doses significantly reduced pulmonary capillary wedge pressure ( 6.4 4.1 mm Hg, 5.7 4.6 mm Hg, 5.7 4.3 mm Hg, and 4.2 4.6 mm Hg for the 15-mg, 30-mg, 60-mg, and placebo groups, respectively; p 0.05 for all tolvaptan vs. placebo). Tolvaptan also reduced right atrial pressure ( 4.4 6.9 mm Hg [p 0.05], 4.3 4.0 mm Hg [p 0.05], 3.5 3.6 mm Hg, and 3.0 3.0 mm Hg for the 15-mg,...

Changes in the mean pulmonary wedge pressure were measured during temporary disconnection from a ventilator in 29 patients to assess the effects of therapy with controlled-volume ventilation on determinations of pulmonary wedge pressure. In 16 observations performed during therapy with intermittent positive-pressure ventilation, the mean value for the pulmonary wedge pressure was the same (10.3...

The present study aimed to explore the prevalence of pre-capillary pulmonary hypertension (PH) and characterise haemodynamic vascular responses to physical exercise in chronic obstructive pulmonary disease (COPD) outpatients, where left ventricular dysfunction and comorbidities were excluded. 98 patients with COPD underwent right heart catheterisation at rest and during supine exercise. Mean pu...

BACKGROUND Orthostatic intolerance after bed rest is characterized by hypovolemia and an excessive reduction in stroke volume (SV) in the upright position. We studied whether the reduction in SV is due to a specific adaptation of the heart to head-down tilt bed rest (HDTBR) or acute hypovolemia alone. METHODS AND RESULTS We constructed left ventricular (LV) pressure-volume curves from pulmona...

Plasma colloid osmotic pressure was reduced by 76% (from 19.6 +/- 0.6 to 4.7 +/- 1.5 mm Hg) in five baboons while pulmonary capillary hydrostatic pressure was maintained at a normal level. This resulted in fluid retention, weight gain, peripheral edema and ascites, but no pulmonary edema. Thoracic duct lymph flow increased 6-fold and pulmonary lymph flow 7-fold. Thoracic duct lymph had a lower ...

THE behavior of the pulmonary vascular resistance during exercise in patients with ventricular septal defect or patent ductus arteriosus influences the magnitude and direction of tlhe shunt of blood across the defect and also may provide clues concerning the genesis of the pulmonary hypertension often seen in large defects. In previous studies,1' 2 pulmonary artery wedge pressure had not been d...