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Review
. 2025 Sep;168(3):763-779.
doi: 10.1016/j.chest.2025.05.009. Epub 2025 May 16.

Best Practices for Right Heart Catheterization in the Diagnosis of Pulmonary Hypertension

Yuri Matusov  1 , Nicholas A Kolaitis  2 , Dael Geft  3 , Jacqueline DesJardin  4 , Christopher Barnett  4 , Antoine Hage  3 , Teresa De Marco  4 , Michael I Lewis  5
Affiliations
Review

Best Practices for Right Heart Catheterization in the Diagnosis of Pulmonary Hypertension

Yuri Matusov et al. Chest. 2025 Sep.

Abstract

Right heart catheterization is the gold standard for the diagnosis of pulmonary hypertension. There are variations in practice and several pitfalls introducing errors in diagnosis that can significantly affect treatment. Errors in assessing the correct pulmonary artery wedge pressure can significantly affect accurate classification of patients with pulmonary hypertension and lead to potentially deleterious treatment decisions. This review focuses on best practices in right heart catheterization performance, emphasizing practical and pathophysiological principles to obtain the most accurate result, as well as advanced applications in pulmonary hypertension.

Keywords: heart failure with preserved ejection fraction; pulmonary arterial hypertension; pulmonary hypertension; right heart catheterization; right ventricular failure.

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Conflict of interest statement

Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: Y. M. reports research funding from Penumbra, Aerovate, Tenax, and Mallinckrodt; and consulting for Jupiter Endovascular. N. A. K. reports consulting for Merck, Johnson & Johnson, Liquidia, United Therapeutics, and Bayer. D. G. reports research funding from United Therapeutics. C. B. reports consulting for Abiomed and Abbott; and research funding from Merck and Pfizer. A. H. reports research funding from AstraZeneca and Insmed. T. D. reports research funding from CareDx; consulting for Acceleron/Merck, Johnson & Johnson/Actelion/Janssen, Aerovate, Alexion, Imricor, Keros, Pulnovo, Tectonic, and Corsair; and advisory board for Kamada. None declared (J. D., M. I. L.).

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