Right heart catheterization and risk stratification in advanced heart failure

Michael Craig, Naveen L. Pereira

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Right heart catheterization (RHC) has remained the gold standard in diagnosing elevated cardiac filling pressures. Despite advances in medical therapy, patients with persistent volume overload and heart failure (HF) have a poor prognosis. The diagnosis of volume overload can be difficult in advanced HF with clinical symptoms and signs often lacking sensitivity and specificity. Hemodynamic measurements at rest, especially pulmonary capillary wedge pressure and change in pulmonary capillary wedge pressure, have been closely linked to prognosis. However, RHC is invasive with attendant risks of complications. Noninvasive models without using catheterization-derived values have been shown to be equally predictive of survival. In selected clinical situations, especially the cardiorenal syndrome, RHC continues to play an important role. Newer invasive and noninvasive techniques to assess volume status are available, but large prospective trials are lacking. The advantage with continuous hemodynamic monitoring could be the development of an early warning system prior to the onset of symptomatic decompensation.

Original languageEnglish (US)
Pages (from-to)143-152
Number of pages10
JournalCurrent heart failure reports
Volume3
Issue number3
DOIs
StatePublished - Sep 1 2006

ASJC Scopus subject areas

  • Emergency Medicine
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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