This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bossone, E. Articles by Armstrong, W. F. Search for Related Content PubMed PubMed Citation Articles by Bossone, E. Articles by Armstrong, W. F.

CLINICAL STUDIES

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

^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

This article has been cited by other articles:

				H. Mahjoub, F. Levy, M. Cassol, P. Meimoun, M. Peltier, D. Rusinaru, and C. Tribouilloy Effects of age on pulmonary artery systolic pressure at rest and during exercise in normal adults Eur J Echocardiogr, July 1, 2009; 10(5): 635 - 640. [Abstract] [Full Text] [PDF]

				E. Grunig, S. Weissmann, N. Ehlken, A. Fijalkowska, C. Fischer, T. Fourme, N. Galie, A. Ghofrani, R. E. Harrison, S. Huez, et al. Stress Doppler Echocardiography in Relatives of Patients With Idiopathic and Familial Pulmonary Arterial Hypertension: Results of a Multicenter European Analysis of Pulmonary Artery Pressure Response to Exercise and Hypoxia Circulation, April 7, 2009; 119(13): 1747 - 1757. [Abstract] [Full Text] [PDF]

				J-W Ha, D Choi, S Park, C-Y Shim, J-M Kim, S-H Moon, H-J Lee, E-Y Choi, and N Chung Determinants of exercise-induced pulmonary hypertension in patients with normal left ventricular ejection fraction Heart, March 15, 2009; 95(6): 490 - 494. [Abstract] [Full Text] [PDF]

				A. La Gerche, A. J. Taylor, and D. L. Prior Athlete's Heart: The Potential for Multimodality Imaging to Address the Critical Remaining Questions. J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 350 - 363. [Abstract] [Full Text] [PDF]

				J. J. Tolle, A. B. Waxman, T. L. Van Horn, P. P. Pappagianopoulos, and D. M. Systrom Exercise-Induced Pulmonary Arterial Hypertension Circulation, November 18, 2008; 118(21): 2183 - 2189. [Abstract] [Full Text] [PDF]

				E. Bossone, R. Citro, W. F. Armstrong, and M. Rubenfire Latent Pulmonary Hypertension: Looking Beyond the Scene Chest, August 1, 2008; 134(2): 469 - 470. [Full Text] [PDF]

				A La Gerche, K A Connelly, D J Mooney, A I MacIsaac, and D L Prior Biochemical and functional abnormalities of left and right ventricular function after ultra-endurance exercise Heart, July 1, 2008; 94(7): 860 - 866. [Abstract] [Full Text] [PDF]

				J. Magne, M. Senechal, P. Mathieu, J. G. Dumesnil, F. Dagenais, and P. Pibarot Restrictive Annuloplasty for Ischemic Mitral Regurgitation May Induce Functional Mitral Stenosis J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1692 - 1701. [Abstract] [Full Text] [PDF]

				S. Kiencke, A. Bernheim, M. Maggiorini, M. Fischler, S. V. Aschkenasy, L. Dorschner, J. Debrunner, K. Bloch, H. Mairbaurl, and H. P. Brunner-La Rocca Exercise-induced pulmonary artery hypertension a rare finding? J. Am. Coll. Cardiol., January 29, 2008; 51(4): 513 - 514. [Full Text] [PDF]

				S. Huez and R. Naeije Exercise stress tests for detection and evaluation of pulmonary hypertension Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H17 - H21. [Abstract] [Full Text] [PDF]

				J.-L. Vachiery and A. Pavelescu Exercise echocardiography in pulmonary hypertension Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H48 - H53. [Abstract] [Full Text] [PDF]

				A. M. Taveira-DaSilva, O. M. Hathaway, V. Sachdev, Y. Shizukuda, C. W. Birdsall, and J. Moss Pulmonary Artery Pressure in Lymphangioleiomyomatosis: An Echocardiographic Study Chest, November 1, 2007; 132(5): 1573 - 1578. [Abstract] [Full Text] [PDF]

				S. S. Jarvis, B. D. Levine, G. K. Prisk, B. E. Shykoff, A. R. Elliott, E. Rosow, C. G. Blomqvist, and J. A. Pawelczyk Simultaneous determination of the accuracy and precision of closed-circuit cardiac output rebreathing techniques J Appl Physiol, September 1, 2007; 103(3): 867 - 874. [Abstract] [Full Text] [PDF]

				G. Tumminello, P. Lancellotti, M. Lempereur, V. D'Orio, and L. A. Pierard Determinants of pulmonary artery hypertension at rest and during exercise in patients with heart failure Eur. Heart J., March 1, 2007; 28(5): 569 - 574. [Abstract] [Full Text] [PDF]

				A. S. McLean, I. Ting, S. J. Huang, and S. Wesley The use of the right ventricular diameter and tricuspid annular tissue Doppler velocity parameter to predict the presence of pulmonary hypertension Eur J Echocardiogr, March 1, 2007; 8(2): 128 - 136. [Abstract] [Full Text] [PDF]

				E. Bossone, R. Citro, F. Blasi, and L. Allegra Echocardiography in Pulmonary Arterial Hypertension: An Essential Tool Chest, February 1, 2007; 131(2): 339 - 341. [Full Text] [PDF]

				V. V. McLaughlin and M. D. McGoon Pulmonary Arterial Hypertension Circulation, September 26, 2006; 114(13): 1417 - 1431. [Full Text] [PDF]

				N. J. Collins Reply to the letter to the editor Eur J Echocardiogr, August 1, 2006; 7(4): 263 - 263. [Full Text] [PDF]

				M. L. Alkotob, P. Soltani, M. A. Sheatt, M. C. Katsetos, N. Rothfield, W. D. Hager, R. J. Foley, and D. I. Silverman Reduced exercise capacity and stress-induced pulmonary hypertension in patients with scleroderma. Chest, July 1, 2006; 130(1): 176 - 181. [Abstract] [Full Text] [PDF]

				E. Grunig, C. Dehnert, D. Mereles, R. Koehler, H. Olschewski, P. Bartsch, and B. Janssen Enhanced Hypoxic Pulmonary Vasoconstriction in Families of Adults or Children With Idiopathic Pulmonary Arterial Hypertension Chest, December 1, 2005; 128(6_suppl): 630S - 633S. [Full Text] [PDF]

				E. Grunig, C. Dehnert, D. Mereles, R. Koehler, H. Olschewski, P. Bartsch, and B. Janssen Enhanced Hypoxic Pulmonary Vasoconstriction in Families of Adults or Children With Idiopathic Pulmonary Arterial Hypertension Chest, December 1, 2005; 128(6_suppl): 630S - 633S. [Full Text] [PDF]

				L. J. Rubin and D. B. Badesch Evaluation and Management of the Patient with Pulmonary Arterial Hypertension Ann Intern Med, August 16, 2005; 143(4): 282 - 292. [Abstract] [Full Text] [PDF]

				E. Bossone, B. D. Bodini, A. Mazza, and L. Allegra Pulmonary Arterial Hypertension: The Key Role of Echocardiography Chest, May 1, 2005; 127(5): 1836 - 1843. [Abstract] [Full Text] [PDF]

				M. McGoon, D. Gutterman, V. Steen, R. Barst, D. C. McCrory, T. A. Fortin, and J. E. Loyd Screening, Early Detection, and Diagnosis of Pulmonary Arterial Hypertension: ACCP Evidence-Based Clinical Practice Guidelines Chest, July 1, 2004; 126(1_suppl): 14S - 34S. [Abstract] [Full Text] [PDF]

				J. H. Newman, R. C. Trembath, J. A. Morse, E. Grunig, J. E. Loyd, S. Adnot, F. Coccolo, C. Ventura, J. A. Phillips III, J. A. Knowles, et al. Genetic basis of pulmonary arterial hypertension: Current understanding and future directions J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 33S - 39S. [Abstract] [Full Text] [PDF]

				R. J. Barst, M. McGoon, A. Torbicki, O. Sitbon, M. J. Krowka, H. Olschewski, and S. Gaine Diagnosis and differential assessment of pulmonary arterial hypertension J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 40S - 47S. [Abstract] [Full Text] [PDF]

				N. Galie, A. L. Hinderliter, A. Torbicki, T. Fourme, G. Simonneau, T. Pulido, N. Espinola-Zavaleta, G. Rocchi, A. Manes, R. Frantz, et al. Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1380 - 1386. [Abstract] [Full Text] [PDF]

				R. S. Finkelhor, S. X. Yang, G. Bosich, and R. C. Bahler Unexplained Pulmonary Hypertension Is Associated With Systolic Arterial Hypertension in Patients Undergoing Routine Doppler Echocardiography Chest, March 1, 2003; 123(3): 711 - 715. [Abstract] [Full Text] [PDF]

				D. Chemla, V. Castelain, P. Herve, Y. Lecarpentier, and S. Brimioulle Haemodynamic evaluation of pulmonary hypertension Eur. Respir. J., November 1, 2002; 20(5): 1314 - 1331. [Abstract] [Full Text] [PDF]

				B. M. McQuillan, M. H. Picard, M. Leavitt, and A. E. Weyman Clinical Correlates and Reference Intervals for Pulmonary Artery Systolic Pressure Among Echocardiographically Normal Subjects Circulation, December 4, 2001; 104(23): 2797 - 2802. [Abstract] [Full Text] [PDF]

				R. P. Blankfield, D. W. Hudgel, A. A. Tapolyai, and S. J. Zyzanski Bilateral Leg Edema, Obesity, Pulmonary Hypertension, and Obstructive Sleep Apnea Arch Intern Med, August 14, 2000; 160(15): 2357 - 2362. [Abstract] [Full Text] [PDF]