Abstract

Pulmonary arterial catheterization (PAC) has been quite often used for bedside evaluation of hemodynamics and cardiac function in Japan. Forrester's subsets based on hemodynamic data obtained by PAC are widely used to predict patients prognosis and to determine the choice of treatment. However, since PAC is an invasive procedure, new classification by Nohria et al. derived from non-invasive physical examination is rather recommended in recently published guidelines. In routine diagnostic cardiac catheterization, most useful index of systolic function is left ventricular ejection fraction. This index is however, dependent on loading conditions and is not a pure index of contractility. As for the index of LV contractility, peak positive dP/dt and its derivatives are used. High fidelity pressure data obtained by catheter-tip manometer is necessary to calculate these indexes. Emax is the most reliable index of contractility although this is not practical for routine evaluation. As for the indexes of relaxation, peak negative dP/dt and tau are calculated from high fidelity pressure data. The ratio of LVEDP to LVEDV is a simple index for diastolic distensibility. For further evaluation of diastolic function, cubersome plotting of left ventricular pressure and volume data is required.

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