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December 4, 2001Circulation680 citationsOpen Access

Clinical Correlates and Reference Intervals for Pulmonary Artery Systolic Pressure Among Echocardiographically Normal Subjects

BMB. McQuillanMPMichael H. PicardMLMichael O. Leavitt

Key Result

Doppler transthoracic echocardiography revealed a mean pulmonary artery systolic pressure of 28.3 mm Hg among 3790 echocardiographically normal subjects, with 28% having a PASP >30 mm Hg.

Study Design

Type

Observational (n=3,790)

Multicenter

Yes

Structured PICO

P
Population
Echocardiographically normal subjects aged 1 to 89 years from a clinical database
O
Outcome
Clinical correlates and reference range for pulmonary artery systolic pressure (PASP)surrogate

In echocardiographically normal subjects, PASP is independently associated with age, BMI, and sex, indicating that normal reference ranges should be adjusted for these factors and may include values up to 40 mm Hg in older or obese individuals.

Main Result

p-value: p=<0.001

Limitations

  • Cross-sectional design limits causal inferences.
  • Sample only included subjects with normal echocardiographic findings.
  • Subjects were not formally screened for conditions known to be associated with elevated PA pressure
  • Assumption of a constant 10 mm Hg for right atrial pressure may overestimate or underestimate true RA pressure
  • Lack of formal reproducibility assessment for peak TR velocity measurements

Abstract

Background Data in normal human subjects on the factors affecting pulmonary artery systolic pressure (PASP) are limited. We determined the correlates of and established a reference range for PASP as determined by Doppler transthoracic echocardiography (TTE) from a clinical echocardiographic database of 102 818 patients, of whom 15 596 (15%) had a normal Doppler TTE study. Methods and Results A normal TTE was based on normal cardiac structure and function during complete Doppler TTE studies. The PASP was calculated by use of the modified Bernoulli equation, with right atrial pressure assumed to be 10 mm Hg. Among TTE normal subjects, 3790 subjects (2432 women, 1358 men) from 1 to 89 years old had a measured PASP. The mean PASP was 28.3±4.9 mm Hg (range 15 to 57 mm Hg). PASP was independently associated with age, body mass index (BMI), male sex, left ventricular posterior wall thickness, and left ventricular ejection fraction ( P 40 mm Hg was found in 6% of those >50 years old and 5% of those with a BMI >30 kg/m 2 . Conclusions Among 3790 echocardiographically normal subjects, PASP was associated with age, BMI, sex, wall thickness, and ejection fraction. Of these subjects, 28% had a PASP >30 mm Hg, and the expected upper limit of PASP may include 40 mm Hg in older or obese subjects. These findings support the use of age- and BMI-corrected values in establishing the expected normal range for PASP.

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Cite This Study

McQuillan et al. (2001) conducted an observational in Pulmonary Artery Systolic Pressure (n=3,790). Doppler Transthoracic Echocardiography vs. Echocardiographically normal subjects was evaluated on Mean Pulmonary Artery Systolic Pressure (PASP) (95% CI 18.7-37.9, p=<0.001). Doppler transthoracic echocardiography revealed a mean pulmonary artery systolic pressure of 28.3 mm Hg among 3790 echocardiographically normal subjects, with 28% having a PASP >30 mm Hg.

synapsesocial.com/papers/6970091f37bf87c8650dab74https://doi.org/10.1161/hc4801.100076
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