Normal values of pulmonary
artery pressure in young healthy
subjects – are values similar to
the general population?
Alon Grossman1 , Alex Prokupetz1, Ori Wand1,
Amit Assa1 ,Michal Benderly2 , Ofra Kalter-Leibovici2
1. Aeromedical Center, Israeli Air Force
2. The Gertner Institute for epidemiology and healthy policy research
affiliated to Tel Aviv University,Tel Hashomer,Israel
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Background
 Cardiovascular assessment has major
implication in the medical screening
process of aircrew candidates.
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Background
 Cardiovascular screening in the Israeli
Air Force includes:
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Medical and family history
Physical examination
Electrocardiogram
Echocardiography
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Introduction
 TTE has been validated for the noninvasive
assessment of cardiac structure and
function.
 TR jet peak velocity predicts PASP
observed by invasive measurements.
 Normal upper limit of PASP is lower than
30mmHg in studies.
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TTE – Transthoracic Echocardiography
TR-Tricuspid Regurgitation
PASP – Pulmonary Artery Systolic Pressure
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Methods
 Routine echo studies was preformed
between 1994-2010.
 Echo was routinely preformed before
recruitment to flight academy.
 Echo studies for clinical indications
were excluded.
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Results
 Control group - 6598 echo were
interpreted as normal .
 Study group - 1900 studies demonstrated
TR enabling measurement of PASP .
 Values for PASP ranged from 10+5mmHg
to 35+5mmHg.
PASP – Pulmonary Artery Systolic Pressure
TR- Tricuspid Regurgitation
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Results
 95% limit for PASP was 29+5mmHg
(34 mmHg).
 Upper that 99% limit for PASP
was 34+5mmHg (39 mmHg).
 PASP was correlated with the LVED
and LVES.
PASP – Pulmonary Artery Systolic Pressure
LVED – Left Ventricular End Diastolic Diameter
LVES - Left Ventricular End Systolic Diameter
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Discussion
 Previous studies among normal and
heterogeneity population the PASP was
reported 26.6-29.3mmHg.
 Age is the strongest predictor of PASP,
increase of 1mmHg for every decade of
age .
 It is crucial to determine the normal range
of PASP.
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PASP – Pulmonary Artery Systolic Pressure
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Discussion
 PASP values may be high as 40mmHq in
general population, include obese and
elderly subjects.
 The values of PASP was 34mmHq in 95th %
of the subjects in our study.
 Higher PASP values may be present in
young athletes subjects.
PASP – Pulmonary Artery Systolic Pressure
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Discussion
 A previous study found a correlation
between BSA and BP and PASP.
 In our study a correlation was found
between LVED and LVES and PASP.
PASP – Pulmonary Artery Systolic Pressure
BSA – Body Surface Area
BP – Blood Pressure
LVED – Left Ventricular End Diastolic Diameter
LVES - Left Ventricular End Systolic Diameter
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Study limitation
 The subjects were evaluated at a single
time point and no follow-up was
performed.
 Population evaluated is a highly selected
one, thus preventing generalization to
other populations.
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Conclusions
 Values of PASP in young healthy
subjects may be higher than those
observed in the general population.
PASP – Pulmonary Artery Systolic Pressure
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Thank you
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