Normal values of pulmonary artery pressure in young healthy subjects

1
Normal values of pulmonary artery pressure in
young healthy subjects are values similar to
the general population?

• Alon Grossman1 , Alex Prokupetz1, Ori Wand1,
• Amit Assa1 ,Michal Benderly2 , Ofra
  Kalter-Leibovici2 1. Aeromedical Center, Israeli
  Air Force
• 2. The Gertner Institute for epidemiology and
  healthy policy research affiliated to Tel Aviv
  University,Tel Hashomer,Israel

2
Background

• Cardiovascular assessment has major implication
  in the medical screening process of aircrew
  candidates.

3
Background

• Cardiovascular screening in the Israeli Air
  Force includes
• Medical and family history
• Physical examination
• Electrocardiogram
• Echocardiography

4
Introduction

• TTE has been validated for the noninvasive
  assessment of cardiac structure and function.
• TR jet peak velocity predicts PASP observed by
  invasive measurements.
• Normal upper limit of PASP is lower than
• 30mmHg in studies.
• TTE Transthoracic Echocardiography
• TR-Tricuspid Regurgitation
• PASP Pulmonary Artery Systolic Pressure

5
Methods

• Routine echo studies was preformed between
  1994-2010.
• Echo was routinely preformed before recruitment
  to flight academy.
• Echo studies for clinical indications were
  excluded.

6
Results

• Control group - 6598 echo were interpreted as
  normal .
• Study group - 1900 studies demonstrated TR
  enabling measurement of PASP .
• Values for PASP ranged from 105mmHg to 355mmHg.
• PASP Pulmonary Artery Systolic Pressure
• TR- Tricuspid Regurgitation

7
Results

• 95 limit for PASP was 295mmHg
• (34 mmHg).
• Upper that 99 limit for PASP
• was 345mmHg (39 mmHg).
• PASP was correlated with the LVED
• and LVES.
• PASP Pulmonary Artery Systolic Pressure
• LVED Left Ventricular End Diastolic Diameter
• LVES - Left Ventricular End Systolic Diameter

8
Discussion

• Previous studies among normal and heterogeneity
  population the PASP was reported 26.6-29.3mmHg.
• Age is the strongest predictor of PASP, increase
  of 1mmHg for every decade of age .
• It is crucial to determine the normal range of
  PASP.
• PASP Pulmonary Artery Systolic Pressure

9
Discussion

• PASP values may be high as 40mmHq in general
  population, include obese and elderly subjects.
• The values of PASP was 34mmHq in 95th of the
  subjects in our study.
• Higher PASP values may be present in young
  athletes subjects.
• PASP Pulmonary Artery Systolic Pressure

10
Discussion

• A previous study found a correlation between BSA
  and BP and PASP.
• In our study a correlation was found between LVED
  and LVES and PASP.
• PASP Pulmonary Artery Systolic Pressure
• BSA Body Surface Area
• BP Blood Pressure
• LVED Left Ventricular End Diastolic Diameter
• LVES - Left Ventricular End Systolic Diameter

11
Study limitation

• The subjects were evaluated at a single time
  point and no follow-up was performed.
• Population evaluated is a highly selected one,
  thus preventing generalization to other
  populations.

12
Conclusions

• Values of PASP in young healthy subjects may be
  higher than those observed in the general
  population.
• PASP Pulmonary Artery Systolic Pressure

13
Thank you