Noninvasive methods for detecting elevated left-sided cardiac filling pressure

Knowledge of left-sided cardiac filling pressures has an important role in the management of patients with chronic heart failure. However, the use of a pulmonary artery catheter to measure pulmonary capillary wedge pressure is generally reserved for hospitalized patients with decompensated heart failure, leaving only noninvasive means of estimating left heart pressures in the majority of patients. Unfortunately, the routine clinical evaluation of patients with chronic systolic heart failure lacks the sensitivity and specificity needed to accurately assess left atrial pressure. In this review, we focus on noninvasive methods that can reliably predict left-sided filling pressures and may have clinical application in the ambulatory setting.