Pulmonary venous pressure: Relationship to pulmonary artery, pulmonary wedge, and left atrial pressure in normal, lightly sedated dogs

Because pulmonary venous pressure has never been measured, it is unclear whether pulmonary wedge pressure measures left atrial pressure, as commonly assumed, or pressure more upstream in the pulmonary venous or capillary beds. Fluid-filled mean pulmonary artery and pulmonary wedge pressure were compared with pulmonary venous and left atrial pressure obtained with high-fidelity micromanometer catheters in eight lightly sedated dogs over a physiologic range of filling pressures. In all conditions, mean pulmonary wedge pressure was virtually identical (r = 0.99) to mean left atrial pressure (slope = 0.99; intercept = -0.46 mm Hg). At the same time, mean pulmonary venous pressure (17.1 ± 6.5 mm Hg) was intermediate between mean pulmonary artery pressure (20.2 ± 6.2 mm Hg) and mean pulmonary wedge pressure (13.3 ± 6.2 mm Hg; P < 0.0001) or mean left atrial pressure (13.4 ± 6.3 mm Hg; P < 0.0001). These relationships were maintained over normal and increased pressure ranges. As measured by conventional flow-directed pulmonary catheters, mean pulmonary wedge pressure accurately reflects left atrial pressure in lightly sedated, spontaneously breathing normal dogs.