Exercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences
Exercise stress echocardiography has not been recommended in the diagnostic workup of pulmonary hypertension because of insufficient certainty about feasibility and limits of normal. Doppler echocardiography pulmonary hemodynamic measurements were performed at a progressively increased workload in 5...
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| Veröffentlicht in: | Chest 2012-11, Vol.142 (5), p.1158-1165 |
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| creator | ARGIENTO, Paola VANDERPOOL, Rebecca R MULE, Massimiliano GIOVANNA RUSSO, Maria D'ALTO, Michele BOSSONE, Eduardo CHESLER, Naomi C NAEIJE, Robert |
| description | Exercise stress echocardiography has not been recommended in the diagnostic workup of pulmonary hypertension because of insufficient certainty about feasibility and limits of normal.
Doppler echocardiography pulmonary hemodynamic measurements were performed at a progressively increased workload in 56 healthy male and 57 healthy female volunteers aged 19 to 63 years. Mean pulmonary artery pressure (mPAP) was estimated from the maximal tricuspid regurgitation jet velocity. Cardiac index was calculated from the left ventricular outflow velocity-time integral. Pulmonary vascular distensibility a index, the percentage change of vessel diameter permm Hg of mPAP, was calculated from multipoint mPAP-cardiac output (CO) plots.
Peak exercise at 175 ±50 W was associated with an mPAP of 33±7 mm Hg and a CO of 18 ±5 L/min. The slope of mPAP-CO relationships was 1.5 ± 0.5 mm Hg/L/min, and the distensibility coefficient ( α ) was 1.3%± 1.0%/mm Hg. Maximal workload and cardiac index were higher in men than in women ( P , .05), but mPAP-cardiac index relationships were not different. However,women had a higher a (1.6%± 1.3%/mm Hg vs 1.1%± 0.6%/mm Hg, P < .05). The average mPAP-cardiac index slope was higher and a lower in subjects ≥50 years old. Upper limits of normal of mPAP at exercise were 34 mm Hg at a CO , 10 L/min, 45 mm Hg at a CO |
| doi_str_mv | 10.1378/chest.12-0071 |
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Doppler echocardiography pulmonary hemodynamic measurements were performed at a progressively increased workload in 56 healthy male and 57 healthy female volunteers aged 19 to 63 years. Mean pulmonary artery pressure (mPAP) was estimated from the maximal tricuspid regurgitation jet velocity. Cardiac index was calculated from the left ventricular outflow velocity-time integral. Pulmonary vascular distensibility a index, the percentage change of vessel diameter permm Hg of mPAP, was calculated from multipoint mPAP-cardiac output (CO) plots.
Peak exercise at 175 ±50 W was associated with an mPAP of 33±7 mm Hg and a CO of 18 ±5 L/min. The slope of mPAP-CO relationships was 1.5 ± 0.5 mm Hg/L/min, and the distensibility coefficient ( α ) was 1.3%± 1.0%/mm Hg. Maximal workload and cardiac index were higher in men than in women ( P , .05), but mPAP-cardiac index relationships were not different. However,women had a higher a (1.6%± 1.3%/mm Hg vs 1.1%± 0.6%/mm Hg, P < .05). The average mPAP-cardiac index slope was higher and a lower in subjects ≥50 years old. Upper limits of normal of mPAP at exercise were 34 mm Hg at a CO , 10 L/min, 45 mm Hg at a CO <20 L/min, and 52 mm Hg at a CO<30 L/min. These values are in keeping with previously reported invasive measurements.
Exercise stress echocardiography of the pulmonary circulation is feasible and allows for fl ow-corrected definition of upper limits of normal. Women have a more distensible pulmonary circulation.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.12-0071</identifier><identifier>PMID: 22539647</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: American College of Chest Physicians</publisher><subject>Adult ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular system ; Echocardiography, Stress ; Female ; Hemodynamics - physiology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Original Research ; Pneumology ; Pulmonary Circulation - physiology ; Reference Values ; Sex Factors ; Ultrasonic investigative techniques</subject><ispartof>Chest, 2012-11, Vol.142 (5), p.1158-1165</ispartof><rights>2015 INIST-CNRS</rights><rights>2012 American College of Chest Physicians 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26593967$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22539647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ARGIENTO, Paola</creatorcontrib><creatorcontrib>VANDERPOOL, Rebecca R</creatorcontrib><creatorcontrib>MULE, Massimiliano</creatorcontrib><creatorcontrib>GIOVANNA RUSSO, Maria</creatorcontrib><creatorcontrib>D'ALTO, Michele</creatorcontrib><creatorcontrib>BOSSONE, Eduardo</creatorcontrib><creatorcontrib>CHESLER, Naomi C</creatorcontrib><creatorcontrib>NAEIJE, Robert</creatorcontrib><title>Exercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences</title><title>Chest</title><addtitle>Chest</addtitle><description>Exercise stress echocardiography has not been recommended in the diagnostic workup of pulmonary hypertension because of insufficient certainty about feasibility and limits of normal.
Doppler echocardiography pulmonary hemodynamic measurements were performed at a progressively increased workload in 56 healthy male and 57 healthy female volunteers aged 19 to 63 years. Mean pulmonary artery pressure (mPAP) was estimated from the maximal tricuspid regurgitation jet velocity. Cardiac index was calculated from the left ventricular outflow velocity-time integral. Pulmonary vascular distensibility a index, the percentage change of vessel diameter permm Hg of mPAP, was calculated from multipoint mPAP-cardiac output (CO) plots.
Peak exercise at 175 ±50 W was associated with an mPAP of 33±7 mm Hg and a CO of 18 ±5 L/min. The slope of mPAP-CO relationships was 1.5 ± 0.5 mm Hg/L/min, and the distensibility coefficient ( α ) was 1.3%± 1.0%/mm Hg. Maximal workload and cardiac index were higher in men than in women ( P , .05), but mPAP-cardiac index relationships were not different. However,women had a higher a (1.6%± 1.3%/mm Hg vs 1.1%± 0.6%/mm Hg, P < .05). The average mPAP-cardiac index slope was higher and a lower in subjects ≥50 years old. Upper limits of normal of mPAP at exercise were 34 mm Hg at a CO , 10 L/min, 45 mm Hg at a CO <20 L/min, and 52 mm Hg at a CO<30 L/min. These values are in keeping with previously reported invasive measurements.
Exercise stress echocardiography of the pulmonary circulation is feasible and allows for fl ow-corrected definition of upper limits of normal. Women have a more distensible pulmonary circulation.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Echocardiography, Stress</subject><subject>Female</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Original Research</subject><subject>Pneumology</subject><subject>Pulmonary Circulation - physiology</subject><subject>Reference Values</subject><subject>Sex Factors</subject><subject>Ultrasonic investigative techniques</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkEtLxDAUhYMoOj6WbiUbwU01ryYTF4KM4wMGFcZ9uZOmNtI2Y9KK_nszOL5Wl3vvxzmHg9AhJaeUq_GZqW3sTynLCFF0A42o5jTjueCbaERIunOp2Q7ajfGFpJ1quY12GMu5lkKNkJm-22BctHjeBxsjnpraGwil888BlvUH9hXua4sfh6b1HYQPPHHBDA30znfneOZa18cVdO9DCw2GrsRz-46vXFXZYDtj4z7aqqCJ9mA999DT9fRpcpvNHm7uJpezbMm07DNZKqU4pWPCNOQqB5XyCs1MaUWldA5aA1OLXJRiDHohx5otCK2MlAC6VHwPXXzJLodFa0tjuz5AUyyDa1PswoMr_n86VxfP_q3gQguhSBI4WQsE_zqkWovWRWObBjrrh1hQprhSTIsVevTX68fku9gEHK8BiAaaKkCXWv7lZK4TqPgnzZGI5w</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>ARGIENTO, Paola</creator><creator>VANDERPOOL, Rebecca R</creator><creator>MULE, Massimiliano</creator><creator>GIOVANNA RUSSO, Maria</creator><creator>D'ALTO, Michele</creator><creator>BOSSONE, Eduardo</creator><creator>CHESLER, Naomi C</creator><creator>NAEIJE, Robert</creator><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121101</creationdate><title>Exercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences</title><author>ARGIENTO, Paola ; VANDERPOOL, Rebecca R ; MULE, Massimiliano ; GIOVANNA RUSSO, Maria ; D'ALTO, Michele ; BOSSONE, Eduardo ; CHESLER, Naomi C ; NAEIJE, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p296t-6d7773118029a575a7001492cde4f795a99a27b54d48a9b6892b01fc66aa9d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Echocardiography, Stress</topic><topic>Female</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Original Research</topic><topic>Pneumology</topic><topic>Pulmonary Circulation - physiology</topic><topic>Reference Values</topic><topic>Sex Factors</topic><topic>Ultrasonic investigative techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ARGIENTO, Paola</creatorcontrib><creatorcontrib>VANDERPOOL, Rebecca R</creatorcontrib><creatorcontrib>MULE, Massimiliano</creatorcontrib><creatorcontrib>GIOVANNA RUSSO, Maria</creatorcontrib><creatorcontrib>D'ALTO, Michele</creatorcontrib><creatorcontrib>BOSSONE, Eduardo</creatorcontrib><creatorcontrib>CHESLER, Naomi C</creatorcontrib><creatorcontrib>NAEIJE, Robert</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ARGIENTO, Paola</au><au>VANDERPOOL, Rebecca R</au><au>MULE, Massimiliano</au><au>GIOVANNA RUSSO, Maria</au><au>D'ALTO, Michele</au><au>BOSSONE, Eduardo</au><au>CHESLER, Naomi C</au><au>NAEIJE, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>142</volume><issue>5</issue><spage>1158</spage><epage>1165</epage><pages>1158-1165</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Exercise stress echocardiography has not been recommended in the diagnostic workup of pulmonary hypertension because of insufficient certainty about feasibility and limits of normal.
Doppler echocardiography pulmonary hemodynamic measurements were performed at a progressively increased workload in 56 healthy male and 57 healthy female volunteers aged 19 to 63 years. Mean pulmonary artery pressure (mPAP) was estimated from the maximal tricuspid regurgitation jet velocity. Cardiac index was calculated from the left ventricular outflow velocity-time integral. Pulmonary vascular distensibility a index, the percentage change of vessel diameter permm Hg of mPAP, was calculated from multipoint mPAP-cardiac output (CO) plots.
Peak exercise at 175 ±50 W was associated with an mPAP of 33±7 mm Hg and a CO of 18 ±5 L/min. The slope of mPAP-CO relationships was 1.5 ± 0.5 mm Hg/L/min, and the distensibility coefficient ( α ) was 1.3%± 1.0%/mm Hg. Maximal workload and cardiac index were higher in men than in women ( P , .05), but mPAP-cardiac index relationships were not different. However,women had a higher a (1.6%± 1.3%/mm Hg vs 1.1%± 0.6%/mm Hg, P < .05). The average mPAP-cardiac index slope was higher and a lower in subjects ≥50 years old. Upper limits of normal of mPAP at exercise were 34 mm Hg at a CO , 10 L/min, 45 mm Hg at a CO <20 L/min, and 52 mm Hg at a CO<30 L/min. These values are in keeping with previously reported invasive measurements.
Exercise stress echocardiography of the pulmonary circulation is feasible and allows for fl ow-corrected definition of upper limits of normal. Women have a more distensible pulmonary circulation.</abstract><cop>Northbrook, IL</cop><pub>American College of Chest Physicians</pub><pmid>22539647</pmid><doi>10.1378/chest.12-0071</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences Cardiology. Vascular system Cardiovascular system Echocardiography, Stress Female Hemodynamics - physiology Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Original Research Pneumology Pulmonary Circulation - physiology Reference Values Sex Factors Ultrasonic investigative techniques |
| title | Exercise Stress Echocardiography of the Pulmonary Circulation: Limits of Normal and Sex Differences |
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