Normal fluctuations in pulmonary artery pressures and cardiac output in patients with severe left ventricular dysfunction.
BACKGROUND
One barrier to accurate interpretation of changes in hemodynamic pressures and cardiac output is lack of data about what constitutes a normal fluctuation. Few investigators have examined normal fluctuations in these parameters and none have done so in patients with left ventricular dysfunction.


OBJECTIVE
To describe normal fluctuations in pulmonary artery pressures and cardiac output in patients with left ventricular dysfunction.


METHODS
Hemodynamically stable advanced heart failure patients (N=39; 55+/-6 years old; 62% male) with left ventricular dysfunction (mean ejection fraction 22+/-5%) were studied. Cardiac output and pulmonary artery pressures were measured every 15 min for 2 h.


RESULTS
Mean+/-standard deviation fluctuations were as follows: pulmonary artery systolic pressure=7+/-4 mmHg; pulmonary artery diastolic pressure=6+/-3 mmHg; pulmonary capillary wedge pressure=5+/-3 mmHg; cardiac output=0.7+/-0.3 l/min. The coefficient of variation for fluctuations in pulmonary artery systolic pressure was 6.7%, in pulmonary artery diastolic pressure was 9.3%, in pulmonary capillary wedge pressure was 9.2%, and in cardiac output was 7.2%.


CONCLUSIONS
Values that vary <8% for pulmonary artery systolic pressure, <11% for pulmonary artery diastolic pressure, <12% for pulmonary capillary wedge pressure, and <9% for cardiac output from baseline represent normal fluctuations in these parameters in patients with left ventricular dysfunction.
Moser
Debra K
DK
College of Nursing, University of Kentucky, Lexington, KY 40536-0232, USA. dmoser@uky.edu
Frazier
Susan K
SK
Woo
Mary A
MA
Daley
Linda K
LK
D001794:Blood Pressure; D002302:Cardiac Output; D002395:Catecholamines / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000145:classification / Q000503:physiopathology*
D002395:Catecholamines