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June 2018

Comparing Pulmonary Arterial Wedge Pressure and Left Ventricular End Diastolic Pressure for Assessment of Left-Sided Filling Pressures

Author Affiliations
  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
JAMA Cardiol. 2018;3(6):453-454. doi:10.1001/jamacardio.2018.0318

It has become common in both clinical practice and academic literature to use the terms pulmonary arterial wedge pressure (PAWP) and left ventricular end diastolic pressure (LVEDP) interchangeably to describe left-sided filling pressures. Several recent studies have compared the accuracy of these 2 hemodynamic measurements.1-3 However, PAWP and LVEDP do not provide similar information, and the incorrect use of 1 term vs the other can lead to erroneous conclusions on the association of the left heart with patient symptoms and hemodynamic calculations, such as pulmonary arteriolar resistance. Although the right ventricle experiences the total pulmonary resistance (mean pulmonary arteriolar pressure divided by cardiac output), the pulmonary arteriolar resistance helps determine the relative contribution of the left heart vs intrinsic pulmonary vascular disease.