Kingston Heart Clinic, 460 Princess Street, Kingston, Ontario, Canada.
Can J Cardiol. 2010 Feb;26(2):e45-9. doi: 10.1016/s0828-282x(10)70006-4.
To determine the normal range of estimated right ventricular systolic pressure (RVSP) at peak exercise during exercise stress echocardiography (ExECHO) in a series of consecutive patients referred for the investigation of coronary artery disease.
Of 1057 ExECHO examinations over a span of 11 months, 807 met the study criteria. A total of 250 patients were excluded, 188 for missing rest or peak RVSP measurements, 16 for a resting RVSP above 50 mmHg, 16 for nondiagnostic echocardiographic images and the remaining 30 for missing data. The maximal tricuspid regurgitant jet was recorded at rest and following acquisition of the stress images (mean [+/- SD] time 103.1+/-35.2 s). A mean right atrial pressure of 10 mmHg was used in the calculation of RVSP. All data were entered into a cardiology database (CARDIOfile; Registered trademark, Kingston Heart Clinic) for later retrieval and analysis.
There were 206 male (58.9+/-12.0 years of age) and 601 female patients (57.4+/-12.0 years of age). Patient age ranged from 18 to 90 years. The mean resting and peak exercise RVSP was 27.8+/-7.8 mmHg and 34.8+/-11.3 mmHg in men, and 27.8+/-7.7 mmHg and 34.6+/-11.7 mmHg in women, respectively. The mean increase in RVSP was 7.0+/-8.8 mmHg in men and 6.7+/-8.9 mmHg in women. The 95% CI for peak RVSP was 12.2 mmHg to 57.4 mmHg in men, and 11.2 mmHg to 58.0 mmHg in women. There was no significant difference in peak RVSP for a normal ExECHO compared with an abnormal ExECHO. RVSP at rest and at peak exercise increased with both age and left atrial size.
In individual patients, the RVSP should not increase above the resting value by more than 24.6 mmHg in men and 24.5 mmHg in women. This value was calculated as the increase in RVSP plus 2xSD of the RVSP. Peak RVSP should not exceed 57.4 mmHg in men and 58.0 mmHg in women. If either of these criteria is exceeded, the response of RVSP to exercise should be considered abnormal.
在一系列因冠状动脉疾病而接受检查的连续患者中，确定运动超声心动图（ExECHO）中运动峰值时右心室收缩压（RVSP）的正常范围。
在 11 个月的时间内进行了 1057 次 ExECHO 检查，其中 807 次符合研究标准。排除了 250 名患者，188 名患者因缺少休息或峰值 RVSP 测量值而被排除，16 名患者因休息时 RVSP 超过 50mmHg 而被排除，16 名患者因超声心动图图像不可诊断而被排除，其余 30 名患者因数据缺失而被排除。在休息时和获取应激图像后（平均[+/-SD]时间 103.1+/-35.2 秒）记录最大三尖瓣反流射流。在 RVSP 的计算中使用平均右心房压力 10mmHg。所有数据均输入心脏病学数据库（CARDIOfile；注册商标，金斯敦心脏诊所）以供以后检索和分析。
有 206 名男性（58.9+/-12.0 岁）和 601 名女性患者（57.4+/-12.0 岁）。患者年龄从 18 岁到 90 岁不等。男性的平均静息和运动峰值 RVSP 分别为 27.8+/-7.8mmHg 和 34.8+/-11.3mmHg，女性分别为 27.8+/-7.7mmHg 和 34.6+/-11.7mmHg。男性 RVSP 的平均增加值为 7.0+/-8.8mmHg，女性为 6.7+/-8.9mmHg。男性的峰值 RVSP 95%CI 为 12.2mmHg 至 57.4mmHg，女性为 11.2mmHg 至 58.0mmHg。正常 ExECHO 与异常 ExECHO 相比，峰值 RVSP 无显著差异。静息时和运动峰值时的 RVSP 随年龄和左心房大小的增加而增加。
在个体患者中，男性的 RVSP 不应比静息值增加超过 24.6mmHg，女性不应超过 24.5mmHg。此值是 RVSP 的增加值加上 RVSP 的 2xSD。男性的峰值 RVSP 不应超过 57.4mmHg，女性不应超过 58.0mmHg。如果超过了这些标准中的任何一个，则应认为 RVSP 对运动的反应异常。
