Clinical correlates and reference intervals for pulmonary artery systolic pressure among echocardiographically normal subjects

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 tran sthoracic 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 us e of the modified Bernoulli equation, with right atrial pressure assumed to be 10 mm Hg. Among TTE normal subjects, 3790 subjects (2432 women, 1358 me n) 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 <0.001). The estimated upper 95 % limit for PASP among lower-risk subjects was 37.2 mm fig. A PASP > 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 asso ciated with age, BMI, sex, wall thickness, and ejection fraction. Of these subjects, 28% had a PASP > 130 mm Hg, and the expected upper limit of PASP may include 40 min Hg in older or obese subjects. These findings support th e use of age- and BMI-corrected values in establishing the expected normal range for PASP.