Echocardiographic parameters correlate poorly with pulmonary artery catheter-derived right atrial pressure in ischaemic cardiogenic shock

Abstract

Accurate estimation of right atrial pressure (RAP) is crucial in cardiogenic shock, yet echocardiographic surrogates are often unreliable. In this exploratory analysis of 43 patients with ischaemic cardiogenic shock, pulmonary artery catheter-derived RAP was compared with right heart echocardiographic indices. Only right ventricular e' velocity demonstrated a weak correlation with RAP (rho = 0.31, p = 0.04), but did not significantly discriminate elevated pressure. Other Doppler and morphometric measures showed no meaningful associations. Echocardiographic parameters correlated poorly with invasive RAP, indicating that conventional indices cannot reliably substitute for pulmonary artery catheterisation in assessing venous congestion in this population.