{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:32:19Z","timestamp":1791318739587,"version":"4.3.1"},"reference-count":34,"publisher":"European Respiratory Society (ERS)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2013,5,29]]},"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>Although in the pulmonary circulation small pressure differences may alter the categorisation of patients, there is no consensus on a standard zero reference level (ZRL). In the supine position, ZRL is mostly set at \u201c5 cm below anterior thorax surface\u201d, \u201c1\/3 thoracic diameter below anterior thorax surface\u201d, \u201cmid-thoracic level\u201d or \u201c10 cm above table level\u201d.<\/jats:p>\n                  <jats:p>We retrospectively assessed the distance of these four ZRLs from computed tomography-derived right and left atrial centre levels and from one another in patients undergoing right heart catheterisation and calculated the respective differences in pressure readings.<\/jats:p>\n                  <jats:p>\n                    We included 196 consecutive patients. The ZRL at \u201c1\/3 thoracic diameter\u201d was most often (98.5%) level with the right atrium, and the ZRL at \u201cmid-thoracic level\u201d was level with the left atrium (97.4%), revealing a median (range) pressure difference of -0.3 (-3.0\u20131.3) and 0.2 (-2.0\u20131.3) mmHg from the right and left atrial centre level, respectively. The largest differences (8.0 (2.0\u201315.4) mmHg) were found between the ZRLs \u201c5 cm below anterior thorax surface\u201d and \u201c10 cm above table level\u201d. Accordingly, 59%\n                    <jats:italic>versus<\/jats:italic>\n                    80% of patients would be classified with pulmonary hypertension and 7%\n                    <jats:italic>versus<\/jats:italic>\n                    38% with elevated left heart pressures.\n                  <\/jats:p>\n                  <jats:p>The choice of ZRL strongly influences pulmonary pressure readings and pulmonary hypertension classification. 1\/3 thoracic diameter mostly represents the right atrium while the left atrium is best represented by the mid-thoracic level.<\/jats:p>","DOI":"10.1183\/09031936.00050713","type":"journal-article","created":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T23:17:43Z","timestamp":1371856663000},"page":"1586-1594","source":"Crossref","is-referenced-by-count":149,"title":["Zero reference level for right heart catheterisation"],"prefix":"10.1183","volume":"42","author":[{"given":"Gabor","family":"Kovacs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Avian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Olschewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Olschewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2013,6,21]]},"reference":[{"key":"2024102021422720000_42.6.1586.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00139009"},{"key":"2024102021422720000_42.6.1586.2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199706000-00006"},{"key":"2024102021422720000_42.6.1586.3","unstructured":"Fishman A . Dynamics of the Pulmonary Circulation. In : Hamilton W Dow P , eds. Handbook of Physiology. Washington, American Physiological Society, 1963; pp. 1667\u20131743."},{"key":"2024102021422720000_42.6.1586.4","unstructured":"Wood P . Diseases of the Heart and Circulation. London, Eyre and Spottiswoode, 1968."},{"key":"2024102021422720000_42.6.1586.5","unstructured":"Guyton AC Hall JE . Vascular Distensibility and Functions of the Arterial and Venous Systems. In : Guyton AC Hall JE , eds. Textbook of Medical Physiology. 11th Edn. 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Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, Elsevier, 2012."},{"key":"2024102021422720000_42.6.1586.33","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(75)90040-X"},{"key":"2024102021422720000_42.6.1586.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.01.024"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/09031936.00050713","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T01:44:47Z","timestamp":1740361487000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/09031936.00050713"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,21]]},"references-count":34,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2013,11,30]]},"published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1183\/09031936.00050713"],"URL":"https:\/\/doi.org\/10.1183\/09031936.00050713","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,21]]}}}