Evaluation of noninvasive alternatives to right heart catheterization

We mechanocardiographically evaluated 50 patients with acute myocardial infarction, invasively monitored by Swan-Ganz catheters, in order to assess if mechanocardiography could provide reliable hemodynamic informations. The last 25 subjects were also studied by pulsed Doppler echocardiography. Our results confirm the high precision of apexcardiography in assessing mean pulmonary capillary wedge pressure (r = 0.91) while Doppler echocardiography proved itself better than mechanocardiography in assessing cardiac output (r = 0.82 vs r = 0.78). Moreover, Doppler echocardiography allowed a good estimation of mean pulmonary artery pressure (r = 0.81) which cannot be assessed by other noninvasive methods. However, we could not find any clinically useful relationship between Doppler mitralic flow characteristics and mean pulmonary capillary wedge pressure. Therefore noninvasive methods could represent a valid alternative to right heart catheterization provided that an integrated Doppler echocardiographic and mechanocardiographic approach is used.