Chest
Original ResearchPulmonary Vascular DiseaseExercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences
Section snippets
Materials and Methods
One hundred twenty-four volunteers (62 women and 62 men) aged 37 ± 13 years (range, 18-63 years) with a height and weight of 173 ± 9 cm and 70 ± 11 kg, respectively (body surface area, 1.8 ± 0.2) gave an informed consent to the study, which was approved by the ethical committee of the Erasme University Hospital (No. P2011/101; Ref. Eudract/CCB: B406201110799, Brussels, Belgium). The subjects were nonsmokers and were free of any cardiovascular or lung disease. None had a family history of
Results
Good-quality signals were available at all levels of exercise in all subjects. Because 11 subjects had been excluded at an initial echocardiographic evaluation, this corresponds to an 87% recovery rate of a complete exercise stress echocardiography of the pulmonary circulation in healthy adults.
Discussion
The results show that the upper limits of normal for mPAP at stress echocardiography depend on the achieved maximal CO. The previously used cut-off value of 30 mm Hg for the diagnosis of exercise-induced pulmonary hypertension is accurate for a CO below 8 to 10 L/min. Higher upper limits of normal for exercise mPAP, up to 50 mm Hg, are to be considered for higher COs achieved by fit healthy subjects. The results also show, we believe for the first time, that there are no sex differences in PVR,
Acknowledgments
Author contributions: Dr Argiento: contributed to the original design and concept of the study, data acquisition, data analysis, and preparation and critical review of the manuscript.
Dr Vanderpool: contributed to the analysis and interpretation of data and preparation and critical review of the manuscript.
Dr Mulè: contributed to the data acquisition, data analysis, review of echocardiographic images, and critical review of the manuscript.
Dr Russo: contributed to the concept of the study and
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Funding/Support: This work was supported by the National Institutes of Health [1R01HL105598 to NCC], the Funds for Cardiac Surgery [to R. N.], the Fonds de la Recherche Scientifique Médicale [3.4637.09 to R. N.], and the Bureau for International Relations and Cooperation [to R. R. V.].
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.
Drs Argiento and Vanderpool contributed equally to this article.