title: Range in pulmonary artery systolic pressure among highly trained athletes.
abstract: BACKGROUND
  Although the physiologic range of pulmonary artery systolic pressure (PASP) has been reported, data on how it is manifested in athletes are limited. The aim of the present study was to explore the full spectrum of PASP and the long-term training impact in a large population of highly trained athletes.
  
  
  METHODS
  Six hundred fifteen consecutive athletes (370 endurance-trained athletes [ATEs] vs 245 strength-trained athletes [ATSs]; 28.4 ± 10.1 years old) and 230 healthy control subjects (27.5 ± 11.3 years old) underwent transthoracic echocardiography. PASP was estimated by measuring maximal tricuspid regurgitant jet velocity (TRV) with the modified Bernoulli equation. The ratio of TRV to right ventricular outflow tract time-velocity integral (TRV/RVOTTVI) was obtained as a correlate of pulmonary vascular resistance (PVR).
  
  
  RESULTS
  Left ventricular (LV) mass index and ejection fraction did not differ significantly between the two groups of athletes. Conversely, ATSs showed an increased sum of wall thickness and relative wall thickness, whereas LV end-diastolic diameter, LV stroke volume, peak TRV, and PASP were significantly higher in ATEs. The ratio between transmitral E wave and tissue Doppler e' wave was not different among the three groups. The ratio TRV/RVOTTVI was ≤ 0.2 (ie, normal PVR) in all subjects. A TRV value > 2.5 m/s was observed in 76 athletes (12.3%). By multivariable analysis, age (P < .01), type and duration of training (P < .01), and LV stroke volume (P < .001) were the only independent predictors of PASP in athletes.
  
  
  CONCLUSIONS
  This study delineates the full range of resting TRV and derived PASP in highly trained athletes. The upper physiologic limit of PASP in endurance athletes may reach 40 mm Hg, in line with the greater increase in stroke volume. This should be considered a "physiologic phenomenon" when evaluating athletes for sports eligibility.
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.affiliation: Department of Pathophysiology, Erasme University Hospital, Erasme Campus, Brussels, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: D'Alto
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Argiento
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Golia
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Rosangela
authors.initials: R
authors.lastname: Cocchia
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Riegler
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Scarafile
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Limongelli
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.affiliation: Department of Cardiology University of Salerno, Salerno, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Pio
authors.initials: P
authors.lastname: Caso
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
authors.affiliation: Department of Cardiology, Second University Naples, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.affiliation: Department of Cardiac Surgery, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address: ebossone@hotmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
mesh_terms: D000328:Adult; D056352:Athletes; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012016:Reference Values; D012189:Retrospective Studies; D013599:Systole; D018615:Ultrasonography, Doppler, Color