Hemodynamics for the Heart Failure Clinician: A State-of-the-Art Review

J Card Fail. 2022 Jan;28(1):133-148. doi: 10.1016/j.cardfail.2021.07.012. Epub 2021 Aug 10.

Abstract

Heart failure (HF) fundamentally reflects an inability of the heart to provide adequate blood flow to the body without incurring the cost of increased cardiac filling pressures. This failure occurs first during the stressed state, but progresses until hemodynamic derangements become apparent at rest. As such, the measurement and interpretation of both resting and stressed hemodynamics serve an integral role in the practice of the HF clinician. In this review, we discuss conceptual and technical best practices in the performance and interpretation of both resting and invasive exercise hemodynamic catheterization, relate important pathophysiologic concepts to clinical care, and discuss updated, evidence-based applications of hemodynamics as they pertain to the full spectrum of HF conditions.

Keywords: Hemodynamics; cardiac function; cardiogenic shock; heart failure; heart failure with preserved ejection fraction; heart failure with reduced ejection fraction; pulmonary hypertension.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization
  • Exercise Test
  • Exercise Tolerance / physiology
  • Heart Failure* / diagnosis
  • Heart Failure* / therapy
  • Hemodynamics
  • Humans
  • Stroke Volume / physiology