Purpose: To define the normal values for right ventricular systolic pressure (RVSP) for different patient (P) age groups in P with completely normal echocardiograms (ECHO).
Methods : Our cardiology database was searched for all ECHOs with an RVSP measurement. Of 20,879 ECHOs in the database 9,398 have had RVSP measured. ECHOs were excluded for the following reasons; EF ≤60%, LV mass index >120g/m2, any RV pathology, aortic regurgitation with an AR/jet ratio ≥0.20, any aortic valve gradient >16mmHg, mitral regurgitation with an ERO >0.20cm2, mean mitral valve gradient ≥4.0mmHg, any form of cardiomyopathy, any cardiac tumour or masses, any congenital heart disease, any pericardial disease and any abnormal m-mode finding not covered by the previously mentioned categories. After any abnormal ECHOs had been excluded there were 1,577 completely normal ECHOs that were used for analysis. Patients were divided into three age group categories; ≤50yrs, 51-75yrs and >75 years. Statistical analysis was performed using linear regression analysis (LRA) for the whole cohort and analysis of variance, (ANOVA) for comparison of the different age groups. Age ranges for RVSP were calculated using the mean and 2 standard deviations, (95% confidence intervals)
Results: Patient age range was 16-97 years. Mean age was 52 years. LRA showed that RVSP increased progressively with age; r = 0.38, P<0.0001. When age deciles were analyzed, this increase in RVSP occurred for those P over the age of 50 years. Results for the three different age groups defined above are shown in Table 1.
Conclusions: In adult P with a normal ECHO, RVSP is stable until age 50 years, and thereafter increases progressively with age. We believe the normal RVSP ranges should be defined for each ECHO laboratory and used when interpreting the ECHO derived RVSP as an estimate of pulmonary artery pressure.