title: Echocardiographic assessment of pulmonary artery systolic pressure following treadmill stress testing.
abstract: OBJECTIVE
  The use of treadmill stress echocardiography (SE) for the diagnosis of nascent pulmonary hypertension (PH) has been hampered by a lack of well-defined, post-exercise pulmonary artery systolic pressure (PASP) values across representative age groups in a normal cohort.
  
  
  RESULTS
  Five hundred and eleven subjects (mean age: 53 ±14, 68% female) with normal resting PASP were included in the study. All participants performed treadmill exercise using the Bruce protocol to a high level of perceived exertion. PASP was calculated before and immediately after exercise using Doppler assessment of tricuspid regurgitation. For the cohort, post-exercise PASP was 39 ± 7 mmHg (range: 23-64 mmHg) representing an increase of 11 ± 6 mmHg (44%) from resting values (P < 0.001). The 95th centile values for post-exercise PASP were calculated for the following age cohorts: <30 years; 46 mmHg, 31-50 years; 50 mmHg, 51-70 years; 52 mmHg, >70 years; 53 mmHg. There was a modest independent correlation between post-exercise PASP and (i) increasing age and (ii) resting PASP (r2 = 0.35 and 0.49, respectively, P = 0.01).
  
  
  CONCLUSIONS
  An increase of post-exercise PASP was seen in all patients undergoing SE in this study. Age was directly correlated with post-exercise PASP. Using normative data from healthy controls, treadmill SE-derived post-exercise PASP may be a useful adjunct in the diagnosis of PH.
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Arshad A
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al-Omary
authors.affiliation: University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Renner
authors.affiliation: Middlesboro ARH Hospital, Middlesboro, KY, USA.
authors.forename: Ehtesham
authors.initials: E
authors.lastname: Ul Haque
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Avedis
authors.initials: A
authors.lastname: Ekmejian
authors.affiliation: University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Laurent
authors.initials: L
authors.lastname: Quiqueree
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Collins
authors.affiliation: Cardiovascular Department, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW 2310, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Turner
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012307:Risk Factors; D013599:Systole
keywords: pulmonary artery systolic pressure; pulmonary hypertension; stress echocardiography