Pulmonary vascular disease & thromboembolism
Exercise Stress Echocardiography of the Right Ventricle and Pulmonary Circulation
Authors' conclusion
Exercise echocardiography of the pulmonary circulation and the right ventricle discloses prognostically relevant differences between healthy subjects, athletes, high-altitude residents, and patients with various cardio-respiratory conditions.
Study context
- Population
- Healthy subjects, athletes, high-altitude residents and patients with various cardio-respiratory conditions undergoing resting and exercise echocardiography on a semirecumbent cycle ergometer
- Participants
- 2,228 subjects
- Exposure
- RV and pulmonary circulation response to exercise across healthy subjects, athletes, high-altitude residents and patient categories
- Healthy controlsn = 375reference
- Athletesn = 40
- Cardiovascular risk factorsn = 516
- Pulmonary arterial hypertensionn = 17
- Connective tissue diseasesn = 872
- Left-sided heart diseasen = 113
- Lung diseasen = 30
- High altituden = 265
- Outcome
- Normal limits (5th–95th percentile) of exercise RV–pulmonary circulation indices and predictors of mortality
Main finding
As reported in the abstract
- mPAP–cardiac output slope, 5th–95th percentile in healthy subjects without CV risk factors; increased in all patient categories and high-altitude residents
- 0.2 to 3.5 mm Hg.min/L
- TAPSE/sPAP ratio at rest, 5th–95th percentile; decreased in all disease categories and high-altitude residents
- 0.7 to 2.0 mm/mm Hg
- TAPSE/sPAP ratio at peak exercise, 5th–95th percentile; decreased in all disease categories and high-altitude residents
- 0.5 to 1.5 mm/mm Hg
- Increased all-cause mortality predicted by resting TAPSE/sPAP
- <0.7 mm/mm Hg
- Increased all-cause mortality predicted by mPAP–cardiac output
- >5 mm Hg.min/L
Observational data: associations, not effects.
Further findings
All-cause mortality (predictors) · follow-up
- Increased all-cause mortality predicted by resting TAPSE/systolic PAP
- <0.7 mm/mm Hg
- Increased all-cause mortality predicted by mean PAP–cardiac output
- >5 mm Hg.min/L
Original publication
Exercise Stress Echocardiography of the Right Ventricle and Pulmonary Circulation. J Am Coll Cardiol. Published 21 November 2023. doi:10.
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