Document Detail

Estimated right ventricular systolic pressure during exercise stress echocardiography in patients with suspected coronary artery disease.
MedLine Citation:
PMID:  20151058     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the normal range of estimated right ventricular systolic pressure (RVSP) at peak exercise during exercise stress echocardiography (ExECHO) in a series of consecutive patients referred for the investigation of coronary artery disease.
METHODS: Of 1057 ExECHO examinations over a span of 11 months, 807 met the study criteria. A total of 250 patients were excluded, 188 for missing rest or peak RVSP measurements, 16 for a resting RVSP above 50 mmHg, 16 for nondiagnostic echocardiographic images and the remaining 30 for missing data. The maximal tricuspid regurgitant jet was recorded at rest and following acquisition of the stress images (mean [+/- SD] time 103.1+/-35.2 s). A mean right atrial pressure of 10 mmHg was used in the calculation of RVSP. All data were entered into a cardiology database (CARDIOfile; Registered trademark, Kingston Heart Clinic) for later retrieval and analysis.
RESULTS: There were 206 male (58.9+/-12.0 years of age) and 601 female patients (57.4+/-12.0 years of age). Patient age ranged from 18 to 90 years. The mean resting and peak exercise RVSP was 27.8+/-7.8 mmHg and 34.8+/-11.3 mmHg in men, and 27.8+/-7.7 mmHg and 34.6+/-11.7 mmHg in women, respectively. The mean increase in RVSP was 7.0+/-8.8 mmHg in men and 6.7+/-8.9 mmHg in women. The 95% CI for peak RVSP was 12.2 mmHg to 57.4 mmHg in men, and 11.2 mmHg to 58.0 mmHg in women. There was no significant difference in peak RVSP for a normal ExECHO compared with an abnormal ExECHO. RVSP at rest and at peak exercise increased with both age and left atrial size.
CONCLUSIONS: In individual patients, the RVSP should not increase above the resting value by more than 24.6 mmHg in men and 24.5 mmHg in women. This value was calculated as the increase in RVSP plus 2xSD of the RVSP. Peak RVSP should not exceed 57.4 mmHg in men and 58.0 mmHg in women. If either of these criteria is exceeded, the response of RVSP to exercise should be considered abnormal.
David W J Armstrong; Murray F Matangi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  26     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-03-11     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e45-9     Citation Subset:  IM    
Kingston Heart Clinic, 460 Princess Street, Kingston, Ontario, Canada.
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MeSH Terms
Aged, 80 and over
Coronary Artery Disease / diagnosis,  physiopathology*
Echocardiography, Stress / methods*
Exercise Test / methods*
Follow-Up Studies
Middle Aged
Reproducibility of Results
Retrospective Studies
Ventricular Function, Right / physiology*
Ventricular Pressure / physiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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