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Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics

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MELUZÍN Jaroslav HUDE Petr KREJČÍ Jan ŠPINAROVÁ Lenka LEINVEBER Pavel STEPANOVA Radka NEMEC Petr

Rok publikování 2015
Druh Článek v odborném periodiku
Časopis / Zdroj Biomedical Papers of the Faculty of Medicine of Palacký University, Olomouc, Czech Republic
Fakulta / Pracoviště MU

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Citace
Doi http://dx.doi.org/10.5507/bp.2013.016
Obor Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova pulmonary capillary wedge pressure; exercise; wedge pressure recovery
Popis Aim. The aim of our study was to assess the course of immediate post-exercise pulmonary capillary wedge pressure (PCWP) changes to identify the optimal time window for the noninvasive diagnostics of exercise-induced PCWP elevation. Methods and Results. Seventy-one patients at risk of heart failure with normal left ventricular ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization. The ratio of early left ventricular filling velocity (E) to early diastolic mitral annular velocity (e') was used to predict noninvasively exercise-induced PCWP elevation. Fifty-one patients had exercise-induced PCWP elevation >= 8 mmHg and reached peak exercise PCWP >= 20 mmHg. Rapid post-exercise recovery of PCWP within 2 min was achieved in 18 (35.3%) patients. Intermediate post-exercise PCWP recovery at 3 and 4 min was found in 16 (31.4%) patients while late post-exercise PCWP recovery (>= 5 min) was achieved in 17 (33.3%) patients. Conclusion. The course of post-exercise PCWP recovery is highly variable, and a significant proportion of patients have only a brief period (<= 2 min) of exercise-induced PCWP elevation. This fact should be taken into account in noninvasive assessment of exercise-induced PCWP.

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