From the Guidelines
An RVSP of 28 mmHg is considered normal, as it falls within the typical range of 15-30 mmHg in adults at rest. This value represents the pressure generated by the right ventricle during contraction and is an important indicator of pulmonary artery pressure. RVSP is commonly measured using echocardiography by estimating the pressure gradient across the tricuspid valve and adding an estimate of right atrial pressure. According to the study by 1, normal mean pulmonary arterial pressure at rest is 14 to 20 mm Hg, and a mean pulmonary arterial pressure between 21 and 24 mm Hg is of uncertain clinical significance but warrants close follow-up.
The diagnosis of pulmonary hypertension is typically made when the mean pulmonary arterial pressure exceeds 25 mm Hg at rest, as measured by right heart catheterization [ 1 ]. In this context, an RVSP of 28 mmHg would not be indicative of pulmonary hypertension. The American College of Cardiology/American Heart Association guidelines for the management of adults with congenital heart disease suggest that a peak RV systolic pressure of less than 35 mm Hg is considered the upper limit of normal [ 1 ].
Key points to consider include:
- The normal range for RVSP is typically between 15-30 mmHg in adults at rest [ 1 ]
- An RVSP of 28 mmHg does not exceed the upper limit of normal, which is 35 mm Hg [ 1 ]
- Regular cardiovascular check-ups are recommended as part of routine health maintenance, especially if there are risk factors for heart or lung disease
- Pulmonary hypertension can result from various conditions, including left heart disease, lung disease, pulmonary embolism, or primary pulmonary arterial hypertension [ 1 ]
From the Research
RVSP Measurement
- The study 2 categorized RVSP as follows: normal (< 40 mm Hg), severely elevated (≥ 60 mm Hg), moderately elevated (50-59 mm Hg), or mildly elevated (40-49 mm Hg).
- Based on this categorization, an RVSP of 28 mmHg would be considered normal.
Comparison with Other Studies
- The other studies 3, 4, 5, 6 focused on the treatment of pulmonary arterial hypertension using sildenafil, and did not provide specific information on the normal range of RVSP.
- However, study 4 reported a mean pulmonary arterial pressure reduction of -3.8 mm Hg with the addition of sildenafil to epoprostenol therapy, but did not provide information on the normal range of RVSP.
RVSP and Pulmonary Hypertension
- Study 2 found that elevated RVSP was associated with adverse outcomes in patients with heart failure.
- The other studies 3, 4, 5, 6 discussed the treatment of pulmonary arterial hypertension, but did not provide direct information on the normal range of RVSP or its relationship to pulmonary hypertension.