From the Guidelines
Normal pulmonary artery (PA) pressures are defined as a mean pulmonary arterial pressure (PAPm) below 25 mmHg, with an upper limit of normal approximately 20 mmHg, as assessed by right heart catheterization (RHC) 1. When evaluating PA pressures, it's essential to consider the clinical context and potential risk factors for developing pulmonary arterial hypertension (PAH).
- The normal PAPm at rest is 14 ± 3 mmHg, with an upper limit of normal of approximately 20 mmHg, as stated in the 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension 1.
- Patients with a PAPm between 21 and 24 mmHg should be carefully followed, especially if they are at risk for developing PAH, such as those with connective tissue disease (CTD) or family members of patients with heritable PAH (HPAH) 1.
- Right heart catheterization (RHC) remains the gold standard for assessing PA pressures and diagnosing pulmonary hypertension, which is defined as a mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest 1.
- Understanding normal PA pressure values is crucial for clinicians to accurately diagnose and manage various cardiopulmonary disorders, including pulmonary hypertension, left heart disease, lung disease, and pulmonary embolism.
From the Research
Normal PA Pressures
- Normal pulmonary artery (PA) pressures are not explicitly defined in the provided studies, as they focus on pulmonary arterial hypertension (PAH) and its treatment.
- However, the studies provide information on the effects of various treatments on PA pressures in patients with PAH.
- According to the studies, sildenafil has been shown to decrease pulmonary artery systolic pressures in patients with PAH 2, 3.
- The study by 2 reported a decrease in Doppler-estimated pulmonary artery systolic pressures from 75.33+/-19.75 mmHg to 55.33+/-16.52 mmHg after treatment with sildenafil.
- The study by 3 reported a reduction in mean pulmonary-artery pressure with sildenafil treatment, with the greatest reduction seen in the 80 mg group.
- Another study 4 found that sildenafil, when added to bosentan therapy, did not significantly improve 6-min walk distance or reduce PA pressures compared to placebo.
- It is essential to note that these studies were conducted in patients with PAH, and the results may not be applicable to individuals with normal PA pressures.
- There is no direct information on normal PA pressures in the provided studies, and further research would be needed to determine the normal range of PA pressures.