Comparison of pressure in lesser circulation with left ventricular filling pressure in patients with ischemic heart disease.

Abstract

The left ventricle (LV) was catheterized without X-ray control by a thin teflon catheter introduced through the right brachial artery. Shaping of the catheter allowed entering LV in more than 95% of patients and its safe placements in LV cavity without causing ectopic beats or other complications. Pressures in the pulmonary circulation (PAP, PAPd, PCW) do not reflect left ventricular filling pressure (LVEDP) precisely, particularly when the LVEDP is elevated. The assessment of pathological LV filling pressure from the pulmonary arterial pressures shows, that there was high percentage of false negative results at rest, but during exercise the abnormal values of LVEDP could be predicted from the pulmonary artery pressures. However, PCW or PAPd cannot be considered as identical with LVEDP. For the rough assessment of apparent left ventricular failure it is sufficient to measure pressures in the pulmonary artery. However, for the exact study, the LV should be catheterized. The described bed-side method fulfill all requirements: it is simple, convenient and safe; the pressure is recorded accurately; the procedure can be repeated and is therefore recommended for wider use.