Right heart catheterization in heart failure: indications, interpretation, and pitfalls

Area of Science:

• Cardiology
• Cardiovascular Physiology
• Medical Diagnostics

Background:

• Right heart catheterization (RHC) is essential for managing heart failure (HF) across all disease stages.
• Hemodynamic data from RHC are vital for recognizing clinical deterioration, prognostication, and treatment guidance.

Purpose of the Study:

• To provide a practical guide for clinicians on hemodynamic assessment, troubleshooting, and interpretation using RHC.
• To focus on contextualizing hemodynamic variables with clinical presentation to prevent misclassification.

Main Methods:

• This review synthesizes current knowledge on RHC in heart failure management.
• It emphasizes practical application for acute heart failure, cardiogenic shock, and advanced HF requiring LVAD or transplant evaluation.

Main Results:

• RHC provides critical hemodynamic parameters for diagnosing and managing heart failure.
• Accurate interpretation requires integrating data with the patient's clinical context.

Conclusions:

• RHC is indispensable for comprehensive heart failure care, from ambulatory to end-stage disease.
• Future research should explore novel hemodynamic parameters and non-invasive monitoring technologies.