Exercise Doppler echocardiography derived upper limits of normal are: peak sPAP 60 mmHg, mPAP 40 mmHg, and mPAP/CO slope 3 mmHg/L.min in healthy subjects.
What are the normal reference ranges and upper limits of normal for exercise Doppler echocardiography derived pulmonary pressures in healthy subjects?
This meta-analysis establishes upper limits of normal for exercise echocardiography-derived pulmonary pressures, including an mPAP/CO slope ULN of 3 mmHg/L.min, to aid in the noninvasive detection of exercise pulmonary hypertension.
Absolute Event Rate: 0% vs 0%
Abstract Background Exercise pulmonary hypertension (Ex-PH) was invasively defined as mean pulmonary artery pressure (mPAP)/ cardiac output (CO) slope 3mmHg/L/min between rest and exercise. Supine/semi-recumbent exercise transthoracic Doppler echocardiography (Ex-TTE) (noninvasive, widely available and sustainable) is increasingly used for the detection of Ex-PH and prognostication. However, upper limits of normal (ULN) of Ex-TTE- derived pulmonary pressures are not well established. Purpose The present systematic literature review and meta-analysis aims to comprehensively explore the reference ranges of the Ex-TTE derived-pulmonary pressures in healthy subjects. Methods We performed a comprehensive search strategy for MEDLINE, MEDLINE In-Process 50% suggest substantial heterogeneity. The quality of the included studies and publication bias were assessed. Results Data on 1230 healthy subjects from 14 eligible studies were included. The estimated average peak sPAP was 39 mmHg (95% CI:35-43; ULN: 60 mmHg) (Figure 1a), mPAP was 28 mmHg (95% CI: 23-32; ULN = 40 mmHg) (Figure 1b), mPAP/CO slope was 1.5 mmHg/L.min (95% CI: 1-4-1.7; ULN: 3 mmHg/L.min) (Figure 2). Conclusions The above ULN of Ex-TTE derived pulmonary pressures may represent the reference standard to detect Ex-PH. Further Ex-TTE studies with same methodological robust approach are needed to reduce the variability of the non-invasive measurements.Figure 1 Figure 2
Ferrara et al. (Sat,) reported a other. Exercise Doppler echocardiography derived upper limits of normal are: peak sPAP 60 mmHg, mPAP 40 mmHg, and mPAP/CO slope 3 mmHg/L.min in healthy subjects.