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Range in pulmonary artery systolic pressure among highly trained athletes.
MedLine Citation:
PMID:  20864610     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Although the physiologic range of pulmonary artery systolic pressure (PASP) has been reported, data on how it is manifested in athletes are limited. The aim of the present study was to explore the full spectrum of PASP and the long-term training impact in a large population of highly trained athletes.
METHODS: Six hundred fifteen consecutive athletes (370 endurance-trained athletes [ATEs] vs 245 strength-trained athletes [ATSs]; 28.4 ± 10.1 years old) and 230 healthy control subjects (27.5 ± 11.3 years old) underwent transthoracic echocardiography. PASP was estimated by measuring maximal tricuspid regurgitant jet velocity (TRV) with the modified Bernoulli equation. The ratio of TRV to right ventricular outflow tract time-velocity integral (TRV/RVOTTVI) was obtained as a correlate of pulmonary vascular resistance (PVR).
RESULTS: Left ventricular (LV) mass index and ejection fraction did not differ significantly between the two groups of athletes. Conversely, ATSs showed an increased sum of wall thickness and relative wall thickness, whereas LV end-diastolic diameter, LV stroke volume, peak TRV, and PASP were significantly higher in ATEs. The ratio between transmitral E wave and tissue Doppler e' wave was not different among the three groups. The ratio TRV/RVOTTVI was ≤ 0.2 (ie, normal PVR) in all subjects. A TRV value > 2.5 m/s was observed in 76 athletes (12.3%). By multivariable analysis, age (P < .01), type and duration of training (P < .01), and LV stroke volume (P < .001) were the only independent predictors of PASP in athletes.
CONCLUSIONS: This study delineates the full range of resting TRV and derived PASP in highly trained athletes. The upper physiologic limit of PASP in endurance athletes may reach 40 mm Hg, in line with the greater increase in stroke volume. This should be considered a "physiologic phenomenon" when evaluating athletes for sports eligibility.
Antonello D'Andrea; Robert Naeije; Michele D'Alto; Paola Argiento; Enrica Golia; Rosangela Cocchia; Lucia Riegler; Raffaella Scarafile; Giuseppe Limongelli; Giovanni Di Salvo; Rodolfo Citro; Pio Caso; Maria Giovanna Russo; Raffaele Calabrò; Eduardo Bossone
Publication Detail:
Type:  Journal Article     Date:  2010-09-23
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  788-94     Citation Subset:  AIM; IM    
Via Principe Amedeo, 36, 83023 Lauro (AV), Italy.
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