Table 8. Recommendations for Invasive Evaluation
Recommendations
COR
LOE
I
C
Invasive hemodynamic monitoring can be useful for carefully
selected patients with acute HF with persistent symptoms and/or
when hemodynamics are uncertain
IIa
C
When ischemia may be contributing to HF, coronary
arteriography is reasonable
IIa
C
Endomyocardial biopsy can be useful in patients with HF when a
specific diagnosis is suspected that would influence therapy
IIa
C
Routine use of invasive hemodynamic monitoring is NOT
recommended in normotensive patients with acute HF
III: No
Benefit
B
Endomyocardial biopsy should NOT be performed in the routine
evaluation of HF
III:
Harm
C
Monitoring with a pulmonary artery catheter should be
performed in patients with respiratory distress or impaired
systemic perfusion when clinical assessment is inadequate
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