What is the normal range for Right Ventricular Systolic Pressure (RVSP)?

From the Guidelines

The normal range for right ventricular systolic pressure (RVSP) is less than 35 mm Hg, with a peak RV systolic pressure of less than 35 mm Hg considered the upper limit of normal. This is based on the guidelines from the American College of Cardiology/American Heart Association task force on practice guidelines, as stated in the 2008 guidelines for the management of adults with congenital heart disease 1.

Key Points to Consider

• RVSP is an important hemodynamic parameter that reflects the pressure generated by the right ventricle during contraction.
• Values above 35 mm Hg are generally considered elevated and may indicate pulmonary hypertension or other cardiovascular conditions affecting the right side of the heart.
• RVSP can be affected by various factors including age, body position, altitude, and underlying cardiopulmonary conditions.
• Regular monitoring of RVSP is important in patients with suspected right heart dysfunction, pulmonary hypertension, or congenital heart disease, as changes in this parameter can indicate disease progression or treatment effectiveness.

Clinical Implications

• Patients with RVSP less than 30 mm Hg can be followed up at least every 5 years with a clinical examination and Doppler echocardiogram, as there is little progression in PS severity when the gradient is less than 30 mm Hg 1.
• Those with more significant stenosis should be followed up on a yearly basis.
• Elevated right-sided heart pressures, edema, and ascites can be treated with thiazides, loop diuretics, and aldosterone antagonists as appropriate 1.

From the Research

Normal Range RVSP

The normal range for right ventricular systolic pressure (RVSP) is not explicitly stated in the provided studies. However, the studies do provide information on the effects of various treatments on RVSP in patients with pulmonary arterial hypertension (PAH).

• The study by 2 found that sildenafil reduced RV mass and improved cardiac function and exercise capacity in patients with PAH, but did not provide specific data on RVSP.
• The study by 3 found that sildenafil enhanced contractility and prevented RV dilatation in a rat model of pressure-loaded right ventricle, but did not provide data on RVSP in humans.
• The study by 4 found that combination treatment with bosentan and sildenafil increased right ventricular mitochondrial capacity in a rat model of PAH, but did not provide data on RVSP.
• The study by 5 found that sildenafil significantly decreased pulmonary artery systolic pressure, mean pulmonary artery pressure, and pulmonary vascular resistance in patients with PAH, but did not provide specific data on the normal range for RVSP.
• The study by 6 found that sildenafil improved central hemodynamics and RV function indices in mechanically ventilated patients with WHO group-III PH and RV failure, but did not provide specific data on the normal range for RVSP.

Key Findings

• Sildenafil has been shown to have beneficial effects on RV function and exercise capacity in patients with PAH 2, 6.
• Combination treatment with bosentan and sildenafil may have additional benefits on RV function and mitochondrial capacity 4.
• Sildenafil has been shown to decrease pulmonary artery systolic pressure and pulmonary vascular resistance in patients with PAH 5, 6.

RVSP Values

• The study by 5 reported a significant decrease in pulmonary artery systolic pressure from baseline to peak measurements after sildenafil treatment, with a mean decrease of 14 ± 10 mmHg.
• The study by 6 reported a significant decrease in PVRI from baseline to phase-2 after sildenafil treatment, with a mean decrease of 40% in responders.