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Invasive Hemodynamics

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2 Table 1. Hemodynamic Concepts, Definitions, and Common Clinical Surrogates Concept or term Definition Common surrogates Preload Degree of ventricular stretch at end- diastole Gold standard is EDV; EDP or atrial pressures commonly used as surrogates Aerload Forces opposing ventricular ejection Ea, ESP, SVR, PAR, TPR Effective arterial elastance (Ea) Total arterial load (pulsatile and nonpulsatile); LVESP/SV SBP, SVR Impedance Ratio of the arterial pressure waveform to the blood flow waveform over the entire cardiac cycle; requires spectral and Fourier analysis Systemic vascular resistance (SVR) Describes resistance without consideration of pulsatility; (MAP- RAP)/CO Contractility Strength of contraction in response to ventricular load Ees, EF, δp/δt, SW, CPO Pulmonary vascular resistance (PVR) Describes resistance without consideration of pulsatility; (Mean PAP – mean LAP)/pulmonary flow Pulmonary arterial compliance (PAC) Distensibility of pulmonary artery; C=δv/δp Ventricular diastolic stiffness Slope of EDPVR (δp/δV) – 1 EDP Tau Time constant of myocardial relaxation; represents exponential decay of ventricular pressure during isovolumic relaxation – δp/δt Ventricular interdependence Describes changes in ventricular volumes and pressures mediated by common septum with pericardium intact; examined via comparison of right-sided vs. le-sided pressures RAP, RVSP, LAP, LVSP, SV Diagnosis Key Points ➤ Invasive catheter-based assessments performed in the cardiac catheterization laboratory remain the gold standard for hemodynamic evaluations of cardiovascular patients.

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