![]() ![]() ![]() Uncommonly, mitral stenosis, pulmonary vein stenosis, or pulmonary veno-occlusive disease can also cause a higher PAWP than LVEDP. The discrepancies between LVEDP and mean PAWP are particularly exaggerated in the presence of a large V-wave (which increases the computer-integrated mean PAWP), as in mitral regurgitation, atrial fibrillation with poor atrial operating compliance, or stiff LA syndrome. It measures the instantaneous pressure in the LV that distends the ventricle just prior to the onset of contraction that usually comes after atrial systole. In contrast, the LVEDP provides only information about the LV operating compliance. The mean PAWP that integrates the atrial pressure tracing throughout systole and diastole provides an integrated measure of the hemodynamic burden imposed by the left atrial (LA) operating compliance (and indirectly LV operating compliance) on the pulmonary circulation. It should be noted that PAWP and LVEDP do not provide similar information, and the incorrect use of one term versus the other can lead to erroneous conclusions on the association of the left heart with patient symptoms and hemodynamic calculations, such as pulmonary arteriolar resistance. The terms “pulmonary arterial wedge pressure” (PAWP) and “left ventricular end-diastolic pressure” (LVEDP) are often used interchangeably to describe left-sided filling pressures.The following are key points to remember about pulmonary arterial wedge pressure and left ventricular end-diastolic pressure for assessment of left-sided filling pressures: ![]()
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