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The normal pulmonary arterial pressure-flow relationships during exercise

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  • Cited by (34)

    • Reply: Does PAP/CO Ratio Have a Linear Relationship?

      2020, Journal of the American College of Cardiology
    • Pulmonary Hemodynamics

      2015, Comparative Biology of the Normal Lung: Second Edition
    • Right heart adaptation to pulmonary arterial hypertension: Physiology and pathobiology

      2013, Journal of the American College of Cardiology
      Citation Excerpt :

      These dynamic measures include themean pulmonary arterial pressure–cardiac output slope as well as RV reserve, usually defined either as peak RVEF, peak stroke volume, or peak cardiac index after exercise or pharmacological stress (101,102). In controls, mean pulmonary arterial pressure–cardiac output slope is usually <1.5 to 2.5 mm Hg·min/l, with older healthy subjects having higher average slope values (22,103–113). The committee wants to emphasize that the commonly used indexes of RV systolic performance, such as RVEF and tricuspid annular plane systolic excursion, are markers of ventriculoarterial coupling rather than ventricular contractility, which is increased in PAH (65).

    • Exercise-Induced Pulmonary Hypertension

      2012, Heart Failure Clinics
      Citation Excerpt :

      However, subsequent studies repeatedly reported a linear increase in mean PAP as a function of flow in isolated perfused lungs, as well as in intact human beings studied using the unilateral balloon occlusion technique (to double the flow in the contralateral lung) and/or exercise. In his review of pulmonary hemodynamics at exercise published in 1969, Fowler11 concluded that mean PAP-flow relationships are generally best described by a linear approximation until the highest physiologically possible flows, and that previously reported take-off patterns, or disproportionate increase in PAP at the highest flows, were probably explained by a deterioration of the experimental preparation in isolated perfused lung studies, and either methodological problems or diastolic dysfunction with an increase in LAP in intact human studies. In 1989, Reeves and colleagues12 reviewed the published data on invasive pulmonary hemodynamic measurements at exercise normal subjects.

    • Non-invasive assessment of pulmonary hypertension: Doppler-echocardiography

      2007, Pulmonary Pharmacology and Therapeutics
      Citation Excerpt :

      Moreover, both the positive and the negative predictive values of Doppler-estimated pulmonary artery systolic pressure (PASP) depends not only on sensitivity and specificity, but mainly on differences in the prevalence of PH in the patient's population. Several studies showed a variable correlation between transthoracic Doppler echocardiography (TTE) and right heart catheterisation measurements of PASP mainly depending on the underlying disease, lung conditions, and the time from TTE examination to invasive haemodynamic measurement [1–4]. Non-invasively, PASP is determined by measuring the peak systolic pressure gradient from the right ventricle to the right atrium, calculated as 4 V2 according to the simplified Bernoulli equation, where V is the peak systolic velocity of tricuspid regurgitant flow at continuous wave Doppler.

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    These studies were supported by U.S. Public Health Service Grant HE-06307.

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