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J Am Coll Cardiol, 1999; 33:1662-1666
© 1999 by the American College of Cardiology Foundation
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CLINICAL STUDIES

Range of tricuspid regurgitation velocity at rest and during exercise in normal adult men: implications for the diagnosis of pulmonary hypertension

Eduardo Bossone, MD, PhDa, Melvyn Rubenfire, MD, FACCa, David S. Bach, MD, FACCa, Mark Ricciardi, MDa and William F. Armstrong, MD, FACCa

a Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA

Manuscript received January 23, 1998; revised manuscript received December 3, 1998, accepted January 20, 1999.

Reprint requests and correspondence: Dr. William F. Armstrong, University of Michigan Hospital, Division of Cardiology, Women’s L3119, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109-0273
WFA{at}umich.edu

OBJECTIVES

The aim of this study was to explore the full range of tricuspid valve regurgitation velocity (TRV) at rest and with exercise in disease free individuals. Additionally we examined the relationship of stroke volume (SV), cardiac output (CO) and TRV to exercise capacity.

BACKGROUND

Doppler evaluation of TRV can be used to estimate pulmonary artery systolic pressure (PASP). Most studies have assumed TRV ≤2.5 m/s as the upper limits of normal. The full range of TRV with exercise has been incompletely defined.

METHODS

Highly conditioned athletes (n = 26) and healthy, active, young male volunteers (n = 14) underwent standardized recumbent bicycle exercise. Exercise parameters included: TRV, SV, CO, systolic (SBP) and diastolic (DBP) systemic blood pressure.

RESULTS

Tricuspid valve regurgitation, SV, HR and CO were significantly higher in athletes than in nonathletes over all workloads, including rest. Systolic blood pressure and DBP did not show significant differences between the two groups.

CONCLUSIONS

This study defines the upper physiologic limits of TRV at rest and during exercise in normals and provides a noninvasive standard for the diagnosis of pulmonary hypertension.

Abbreviations and Acronyms
  CO = cardiac output
  DBP = diastolic blood pressure
  EF = ejection fraction
  PASP = pulmonary artery systolic pressure
  RAP = right atrial pressure
  SBP = systolic blood pressure
  SV = stroke volume
  TRV = tricuspid regurgitation velocity




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