TY - JOUR
T1 - "Left ventricular filling pressure(s)" - Ambiguous and misleading terminology, best abandoned
AU - Peverill, R E
PY - 2015
Y1 - 2015
N2 - The use of the terms left ventricular filling pressure and left ventricular filling pressures is widespread in the cardiology literature, but the meanings ascribed to these terms have not been consistent. Left ventricular end-diastolic pressure (LVEDP) and mean left atrial pressure (LAP) cannot be used interchangeably as they will often differ in magnitude in the presence of cardiac disease and they also have different clinical significance. LVEDP is the best pressure to use when considering left ventricular function, whereas mean LAP is the most relevant pressure when considering the tendency to pulmonary congestion. The mean LAP is also the most relevant pressure for determining whether pulmonary hypertension has a left heart (post-capillary) component. If only a left ventricular pressure tracing is available then a technique to measure the mean left ventricular diastolic pressure is the best option for estimating the mean LAP. If only right heart pressures are available then the pulmonary artery end-diastolic pressure will provide a reasonable estimate of LVEDP, but only when the heart and pulmonary circulation are normal. If there is mitral valve disease, left ventricular disease or pulmonary hypertension the LVEDP cannot be estimated from right heart pressures. The problem of the ambiguity of filling pressure (s) is readily solved by the abandonment of this term and the use of either LVEDP or mean LAP as appropriate. ? 2015 Elsevier Ireland Ltd. All rights reserved.
AB - The use of the terms left ventricular filling pressure and left ventricular filling pressures is widespread in the cardiology literature, but the meanings ascribed to these terms have not been consistent. Left ventricular end-diastolic pressure (LVEDP) and mean left atrial pressure (LAP) cannot be used interchangeably as they will often differ in magnitude in the presence of cardiac disease and they also have different clinical significance. LVEDP is the best pressure to use when considering left ventricular function, whereas mean LAP is the most relevant pressure when considering the tendency to pulmonary congestion. The mean LAP is also the most relevant pressure for determining whether pulmonary hypertension has a left heart (post-capillary) component. If only a left ventricular pressure tracing is available then a technique to measure the mean left ventricular diastolic pressure is the best option for estimating the mean LAP. If only right heart pressures are available then the pulmonary artery end-diastolic pressure will provide a reasonable estimate of LVEDP, but only when the heart and pulmonary circulation are normal. If there is mitral valve disease, left ventricular disease or pulmonary hypertension the LVEDP cannot be estimated from right heart pressures. The problem of the ambiguity of filling pressure (s) is readily solved by the abandonment of this term and the use of either LVEDP or mean LAP as appropriate. ? 2015 Elsevier Ireland Ltd. All rights reserved.
UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-84951767376&partnerID=40&md5=97cbd79ae7a8c42a3b2861fd36ab54ef
U2 - 10.1016/j.ijcard.2015.04.254
DO - 10.1016/j.ijcard.2015.04.254
M3 - Article
VL - 191
SP - 110
EP - 113
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -