Raman, Jaishankar, Hu, Raymond, and Bellomo, Rinaldo (2024) Mean Perfusion Pressure and Venous Congestion: Important but Often Forgotten Aspects of Heart Failure. Heart Lung and Circulation, 33 (3). pp. 263-264.

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Abstract

[Extract] In this issue of Heart, Lung and Circulation, Rajagopalan et al. provide evidence that a lower pre-operative mean perfusion pressure was associated with decreased post-operative survival in patients undergoing heart transplantation [1]. Further, their study carefully teased out the contributions of high venous pressure, arterial elastance (Ea) and body surface area (BSA) on the relationship between mean perfusion pressure and survival. This work provides further evidence for individualising therapies—suggesting a need to aim for higher mean perfusion pressure, particularly in those with pre-existing high venous pressure and high BSA, and prudence in quantifying Ea to avoid excessively low Ea. The authors then went a step further to provide a mathematical model of the circulation, which they used to support their clinical observations.

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