ESC Terminology for Pulmonary Capillary Wedge Pressure
Yes, the European Society of Cardiology (ESC) consistently uses "pulmonary artery wedge pressure (PAWP)" rather than "pulmonary capillary wedge pressure (PCWP)" in their guidelines. 1, 2
ESC Guideline Terminology
The ESC/ERS joint guidelines explicitly use PAWP as their standard terminology when defining hemodynamic classifications of pulmonary hypertension 1, 2:
- Pre-capillary PH is defined as: mean PAP ≥25 mmHg with PAWP ≤15 mmHg 1
- Post-capillary PH is defined as: mean PAP ≥25 mmHg with PAWP >15 mmHg 1
The 2015 ESC/ERS guidelines consistently reference PAWP throughout their hemodynamic definitions and classification tables 1. The term appears in their core diagnostic criteria tables where they specify "PAWP ≤15 mmHg" for pre-capillary pulmonary hypertension and "PAWP >15 mmHg" for post-capillary pulmonary hypertension 1.
Measurement Technique Remains Identical
Despite the different terminology, the measurement technique is identical to PCWP 2, 3:
- The pressure is obtained by wedging a balloon-tipped catheter into a small pulmonary arterial branch with the balloon inflated 3
- Measurements must be taken at end-expiration during spontaneous breathing 2, 3
- The external pressure transducer must be zeroed at the mid-thoracic line 3
Clinical Significance
This is purely a nomenclature difference—PAWP and PCWP refer to the exact same hemodynamic measurement. 2, 3 The ESC preference for "PAWP" terminology does not change any clinical thresholds, measurement techniques, or diagnostic criteria. Both terms are used interchangeably in international guidelines, with ESC favoring PAWP while American societies more commonly use PCWP 2, 3.
The measurement remains essential for calculating pulmonary vascular resistance (PVR = [mPAP - PAWP]/CO) and distinguishing pre-capillary from post-capillary pulmonary hypertension 1, 2, 3.