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Figure 1.

Patient flow chart.

LHC, left heart catheterization; LVEDP, left ventricular end-diastolic pressure; mPAP, mean pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure; RHC, right heart catheterization.

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Table 1.

Patient characteristics of the 101 study subjects.

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Table 2.

Hemodynamic Parameters of the 101 study subjects.

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Table 3.

Echocardiographic parameters.

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Figure 2.

Correlation between PCWP and LEDP in the entire study population.

Scatterplot of PCWP and LVEDP pairs for all 101 patients included in the study.

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Figure 3.

Agreement between PCWP and LEDP in the entire study population.

Bland-Altman plot of PCWP and LVEDP pairs for all 101 patients included in the study. Difference indicates difference between PCWP and LVEDP pairs (in mmHg), with positive values indicating that PCWP is higher than corresponding LVEDP for that particular patient, and with negative values indicating that PCWP is lower. Average indicates value of corresponding PCWP and LVEDP pairs divided by 2 ([PCWP+LVEDP/2]). Upper and lower horizontal lines indicate upper and lower borders of 95% limits of agreement, respectively; horizontal line in middle represents mean bias.

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Figure 4.

Correlation and agreement between PCWP and LVEDP in patients with (A, B) or without (C, D) pulmonary hypertension.

Vertical line in (A) divides patients in patients with PCWP ≤15 mmHg or >15 mmHg; horizontal line divides patients in patients with LVEDP ≤15 mmHg or >15 mmHg. Shaded area in (A) represents the patients with PCWP ≤15 mmHg, but LVEDP >15 mmHg, thus indicating patients that would have been incorrectly classified as pre-capillary PH in absence of LVEDP measurement. See fig. 3 for explanation of Bland-Altman plot labeling.

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Figure 5.

Distribution of patients with LVEDP ≤15 mmHg or LVEDP >15 mmHg in patients with PCWP ≤15 mmHg and PVR >3 WU (upper panel; black), TPG >12 mmHg (middle panel; dark grey), or DPG >7 mmHg (bottom panel; light grey).

DPG, diastolic pressure gradient; PVR, pulmonary vascular resistance; TPG, transpulmonary gradient.

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Figure 6.

Area under the receiver operating characteristic curve (AUROC) of PCWP against LVEDP in the entire study population.

(A) AUROC = 0.81 (95% CI, 0.69 to 0.94) using a cut point of LVEDP ≤15 mmHg to indicate pre-capillary PH. (B) If a cut point of LVEDP ≤10 mmHg was used, the AUROC would be 0.89 (95% CI, 0.79 to 0.99). (C) If a cut point of LVEDP ≤20 mmHg was used, the AUROC would be 0.75 (95% CI, 0.63 to 0.88). Sensitivity = sensitivity for the outcome of LVEDP >15 mmHg; Specificity = specificity for the outcome of LVEDP >15 mmHg.

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Figure 7.

Correlations between PCWP and LEDP in patients with or without diabetes (A, B), hypertension (C, D), COPD (E, F) or CHF (G, H), as well as for patients < or ≥65 years of age (I, J), and for patients with a body mass index (BMI) <25 or ≥30 (K, L).

Note lack of significant correlation between PCWP and LVEDP in COPD patients, and poor correlation in obese patients.

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