Predicting Success

Left Ventricular Assist Device Explant and Mitral Valve Replacement for Myocardial Recovery

“…Mean pulmonary artery pressure/cardiac output (CO) slope was 4.4 mm Hg/L per minute (normal ≤3), and pulmonary artery wedge pressure/CO slope was 2.4 mm Hg/L per minute (normal <2; Figure 2). We rely on the pressure/flow relationship instead of single cutoff values to define abnormal exercise response patterns for peak pulmonary artery pressure or pulmonary artery wedge pressure 1 , as single cutoff values do not account for variable degrees to which patients are able to augment flow through the pulmonary circuit during exercise. 2,3 A steep pressure/flow slope throughout exercise (ie, pulmonary artery pressure/CO slope >3 mm Hg/L per minute and PAWP/CO slope >2 mm Hg/L per minute) correlates with exercise intolerance as well as poor prognosis in patients with HF with reduced and preserved EF.…”