What Do You Know About Cardiac Hemodynamics? James Fang, MD Heart Failure/Transplant/VAD Service Harrington-McLaughlin Heart & Vascular Institute University Hospitals Case Medical Center Case Western Reserve University Overview • Hemodynamics – Basic principles and definitions – Hemodynamic guided therapy – Exercise – Constriction and Restriction • Endomyocardial biopsy • Coronary angiography These hemodynamics represent: a) Aortic stenosis b) Aortic regurgitation c) Hypertension d) Coarctation e) Artifact Hemodynamics are only useful if you understand how they were obtained Primary Indications Unclear hemodynamic picture Pulmonary hypertension Consideration of Advanced Therapies Chatterjee K, Circ 2009;119:147-152 Hemodynamic Principles From Grossman’s Cardiac Catheterization, Angiography, and Intervention, 7th Edition Hemodynamic Principles Pressure is only surrogate for volume Burkoff, Maurer, Packer. Circulation 2003;107:656 systolic ejection period diastolic filling period