{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:44:37Z","timestamp":1787856277747,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Right heart catheterization (RHC) is a diagnostic procedure, the main purpose of which is to diagnose pulmonary hypertension and investigate its etiology and treatability. In addition to measuring blood pressure in heart chambers, it includes estimating cardiac output (CO) and calculation of pulmonary vascular resistance (PVR) derived from the CO. There are two common methods to evaluate the CO\u2014the indirect Fick method and the thermodilution method. Depending on the clinical conditions, either of the two may be considered better. Several studies have showed that, in most cases, there is no difference between measurements rendered by the two methods. Other studies have raised suspicion of a discrepancy between the two methods in a substantial number of patients. A clear opinion on this matter is missing. Aim: To evaluate the agreement between the values of the CO and PVR found by the thermodilution and indirect Fick methods. Methods: We retrospectively included patients that underwent RHC in Kaplan Medical Center during the last two years with a measurement of the CO using both the thermodilution and the indirect Fick methods. The measurements obtained upon RHC and the clinical data of the patients were collected. The values of the CO and PVR measured or calculated using the two methods were compared for each patient. Results: We included 55 patients that met the inclusion criteria in this study. The mean CO measured by the thermodilution method was 4.94 \u00b1 1.17 L\/min and the mean CO measured by the indirect Fick method was 5.82 \u00b1 1.97 L\/min. The mean PVR calculated using the thermodilution method was 3.33 \u00b1 3.04 Woods\u2019 units (WU) and the mean PVR calculated using the indirect Fick method was 2.71 \u00b1 2.76 WU. Among the patients with normal mPAP, there was a strong and statistically significant correlation between the PVR values calculated by the two methods (Peasron\u2019s R2 = 0.78, p-value = 0.004), while among the patients with elevated mPAP, the correlation between the PVR values calculated by the two methods was not statistically significant. Conclusion: The findings of this small study demonstrate that, in a proportion of patients, the indirect Fick method and thermodilution method classify the PVR value differently. In our experience, it seems that, in these patients, the indirect Fick method misclassified patients with a pathological finding as normal. We, therefore, recommend that upon performing RHC, at least in patients with mPAP &gt; 25 mmHg, both the thermodilution and indirect Fick methods be performed and, whenever they disagree, the values obtained from the thermodilution method should be preferred.<\/jats:p>","DOI":"10.3390\/jpm13030559","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T03:15:03Z","timestamp":1679368503000},"page":"559","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison between Cardiac Output and Pulmonary Vascular Pressure Measured by Indirect Fick and Thermodilution Methods"],"prefix":"10.3390","volume":"13","author":[{"given":"Igor","family":"Volodarsky","sequence":"first","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Kerzhner","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Kaplan Medical Center, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2897-8919","authenticated-orcid":false,"given":"Dan","family":"Haberman","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeri","family":"Cuciuc","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lion","family":"Poles","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Blatt","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Kirzhner","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Kaplan Medical Center, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"George","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gera","family":"Gandelman","sequence":"additional","affiliation":[{"name":"Heart Center, Kaplan Medical Center, The Hebrew University of Jerusalem, Pasternak St., 1, Rehovot 76100, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1164\/ajrccm.160.2.9811062","article-title":"Determination of Cardiac Output by the Fick Method, Thermodilution, and Acetylene Rebreathing in Pulmonary Hypertension","volume":"160","author":"Hoeper","year":"1999","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/0002-9343(89)90339-2","article-title":"Underestimation of cardiac output by thermodilution in patients with tricuspid regurgitation","volume":"86","author":"Cigarroa","year":"1989","journal-title":"Am. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/0003-4975(92)90342-2","article-title":"Inaccuracy of cardiac output by thermodilution during acute tricuspid regurgitation","volume":"53","author":"Heerdt","year":"1992","journal-title":"Ann. Thorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/00003246-197509000-00002","article-title":"Thermodilution and Fick cardiac index determinations following cardiac surgery","volume":"3","author":"Hodges","year":"1975","journal-title":"Crit. Care Med."},{"key":"ref_5","first-page":"157","article-title":"A comparison between the thermal dilution method and the direct Fick and the dye dilution methods for cardiac output measurements in man","volume":"75","author":"Enghoff","year":"1970","journal-title":"Acta Soc. Med. Ups."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1093\/oxfordjournals.eurheartj.a062505","article-title":"Direct Fick cardiac output: Are assumed values of oxygen consumption acceptable?","volume":"9","author":"Kendrick","year":"1988","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1002\/(SICI)1097-0304(199804)43:4<372::AID-CCD3>3.0.CO;2-5","article-title":"Use of assumed versus measured oxygen consumption for the determination of cardiac output using the Fick principle","volume":"43","author":"Wolf","year":"1998","journal-title":"Catheter. Cardiovasc. Diagn."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.amjcard.2011.10.010","article-title":"Accuracy of Estimating Resting Oxygen Uptake and Implications for Hemodynamic Assessment","volume":"109","author":"Narang","year":"2012","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1097\/00003246-199601000-00016","article-title":"Spirometric versus Fick-derived oxygen consumption: Which method is better?","volume":"24","author":"Thrush","year":"1996","journal-title":"Crit. Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1155\/2012\/261793","article-title":"Thermodilution and Fick cardiac outputs differ: Impact on pulmonary hypertension evaluation","volume":"19","author":"Fares","year":"2012","journal-title":"Can. Respir. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1001\/jamacardio.2017.2945","article-title":"Thermodilution vs Estimated Fick Cardiac Output Measurement in Clinical Practice: An Analysis of Mortality From the Veterans Affairs Clinical Assessment, Reporting, and Tracking (VA CART) Program and Vanderbilt University","volume":"2","author":"Opotowsky","year":"2017","journal-title":"JAMA Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.cardfail.2019.02.004","article-title":"Resting Oxygen Consumption and Heart Failure: Importance of Measurement for Determination of Cardiac Output With the Use of the Fick Principle","volume":"26","author":"Grafton","year":"2019","journal-title":"J. Card. Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/13993003.00879-2022","article-title":"ESC\/ERS Guidelines for diagnosis and treatment of pulmonary hypertension","volume":"61","author":"Humbert","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1056\/NEJM197008272830902","article-title":"Catheterization of the Heart in Man with Use of a Flow-Directed Balloon-Tipped Catheter","volume":"283","author":"Swan","year":"1970","journal-title":"N. Engl. J. Med."},{"key":"ref_15","first-page":"605","article-title":"Theory and application of thermodilution cardiac output measurement: A review","volume":"14","author":"Kadota","year":"1985","journal-title":"Heart Lung"},{"key":"ref_16","first-page":"16","article-title":"Uber die Messung des Blutquantums in Den Herzventrikeln","volume":"1","author":"Fick","year":"1870","journal-title":"Sitz. Der Physmed. Ges. Zu Wurzbg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1113\/jphysiol.1897.sp000684","article-title":"Researches on the circulation time and on the influences, which affect it. The output of the heart","volume":"22","author":"Stewart","year":"1897","journal-title":"J. Physiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/0002-9149(71)90436-X","article-title":"A new technique for measurement of cardiac output by thermodilution in man","volume":"27","author":"Ganz","year":"1971","journal-title":"Am. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/clc.4960050803","article-title":"Oxygen consumption in adult patients during cardiac catheterization","volume":"5","author":"Dehmer","year":"1982","journal-title":"Clin. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1093\/oxfordjournals.eurheartj.a060976","article-title":"Assumed oxygen consumption based on calculation from dye dilution cardiac output: An improved formula","volume":"16","author":"Bergstra","year":"1995","journal-title":"Eur. Hear. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1093\/cvr\/4.1.23","article-title":"The estimation of oxygen consumption","volume":"4","author":"Miettinen","year":"1970","journal-title":"Cardiovasc. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1097\/00003246-199311000-00003","article-title":"Delivery dependent oxygen consumption: Asking the wrong questions and not getting any answers","volume":"21","author":"Smithies","year":"1993","journal-title":"Crit. Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jtcvs.2005.02.048","article-title":"Assumed oxygen consumption frequently results in large errors in the determination of cardiac output","volume":"130","author":"Fakler","year":"2005","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1161\/CIRCULATIONAHA.113.003334","article-title":"Inaccuracy of Estimated Resting Oxygen Uptake in the Clinical Setting","volume":"129","author":"Narang","year":"2014","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1016\/j.amjcard.2015.08.051","article-title":"Comparison of Estimations Versus Measured Oxygen Consumption at Rest in Patients With Heart Failure and Reduced Ejection Fraction Who Underwent Right-Sided Heart Catheterization","volume":"116","author":"Chase","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1161\/01.CIR.78.3.506","article-title":"Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects","volume":"78","author":"Sullivan","year":"1988","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1097\/00005768-199808000-00008","article-title":"Effect of heart failure on muscle capillary geometry: Implications for O2 exchange","volume":"30","author":"Xu","year":"1998","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/ehf2.12237","article-title":"Muscle wasting and sarcopenia in heart failure and beyond: Update 2017","volume":"4","author":"Springer","year":"2017","journal-title":"ESC Heart Fail"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/HJR.0b013e32833f3aa5","article-title":"Exercise intolerance in chronic heart failure: Mechanisms and therapies. Part I","volume":"17","author":"Piepoli","year":"2010","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/0735-1097(94)00568-B","article-title":"Physical training in patients with stable chronic heart failure: Effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles","volume":"25","author":"Hambrecht","year":"1995","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/3\/559\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:59:34Z","timestamp":1760122774000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/3\/559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,20]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["jpm13030559"],"URL":"https:\/\/doi.org\/10.3390\/jpm13030559","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,20]]}}}