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Non-invasive measurement of the response of right ventricular pressure to exercise, and its relation to aerobic capacity

Published online by Cambridge University Press:  13 August 2009

Thomas Möller ,
Kari Peersen ,
Eirik Pettersen ,
Erik Thaulow ,
Henrik Holmstrøm  and
Per Morten Fredriksen
Thomas Möller*
Affiliation:
Pediatric Department, Vestfold Hospital Trust, Tønsberg, Norway
Kari Peersen
Affiliation:
Department of Cardiology, Vestfold Hospital Trust, Tønsberg, Norway
Eirik Pettersen
Affiliation:
Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway
Erik Thaulow
Affiliation:
Pediatric Cardiology, Pulmology and Allergy, Rikshospitalet University Hospital, Oslo, Norway
Henrik Holmstrøm
Affiliation:
Pediatric Cardiology, Pulmology and Allergy, Rikshospitalet University Hospital, Oslo, Norway
Per Morten Fredriksen
Affiliation:
Clinic of Rehabilitation, Rikshospitalet University Hospital, Oslo, Norway
*
Correspondence to: Thomas Möller, MD, Pediatric Department, Vestfold Hospital, Postboks 2168 Postterminalen, N-3103 Tønsberg, Norway. Tel: +47 33342000; Fax: +47 33343975; E-mail: thomas.moller@siv.no
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Abstract

Introduction

Exercise echocardiography assesses exercise-induced pulmonary hypertension. The upper normal limit of right ventricular systolic pressure during exercise is not well established. Our study aims to investigate the response of right ventricular systolic pressure in relation to aerobic capacity.

Methods and results

Cardiopulmonary exercise testing using a treadmill, and echocardiography during supine cycling, were performed in 113 healthy volunteers aged 13 to 25 years. Maximal right ventricular systolic pressure during evaluable exercise studies obtained in 108 subjects showed a Gaussian distribution only after separating the endurance trained subjects, specifically 12 athletes with Z-score of peak oxygen uptake higher than 2.0, from the normally trained group of 97 subjects. Maximal right ventricular systolic pressure during exercise in the normally trained group showed a mean of 38.0 millimetres of mercury, with standard deviation of 7.2, a median value of 39.0, and a range from 17 to 63, and the 95th percentile was 51 millimetres of mercury. In the athletes, the maximal right ventricular systolic pressure was higher, with a median of 55.5, a range from 28 to 69, this being significant, with p equal to 0.004). Of the 12 athletes, 8 (67%) showed a response of right ventricular systolic pressure to exercise exceeding 50 millimetres of mercury, but only 8 of 97 normally trained subjects (8%) showed a similar response, this also being significant, with p less than 0.001.

Conclusions

Our study confirms the great variability in the response of right ventricular systolic pressure to exercise in healthy individuals, with 50 millimetres of mercury representing the upper normal limit. Endurance-trained athletes show higher levels, and two-thirds have abnormal responses exceeding 50 millimetres of mercury.

Keywords

Exercise echocardiographyexercise physiologypulmonary hypertensionpulmonary circulation
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 5 , October 2009 , pp. 465 - 473
Copyright
Copyright © Cambridge University Press 2009

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