{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:47:30Z","timestamp":1788414450865,"version":"build-2803163510"},"reference-count":46,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","award":["an award from the Mayo Department of Cardiovascula"],"award-info":[{"award-number":["an award from the Mayo Department of Cardiovascula"]}],"id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["RO1 HL128526"],"award-info":[{"award-number":["RO1 HL128526"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2019,11,2]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Identification of elevated pulmonary artery pressures during exercise has important diagnostic, prognostic and therapeutic implications. Stress echocardiography is frequently used to estimate pulmonary artery pressures during exercise testing, but data supporting this practice are limited. This study examined the accuracy of Doppler echocardiography for the estimation of pulmonary artery pressures at rest and during exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Simultaneous cardiac catheterisation-echocardiographic studies were performed at rest and during exercise in 97 subjects with dyspnoea. Echocardiography-estimated pulmonary artery systolic pressure (ePASP) was calculated from the right ventricular (RV) to right atrial (RA) pressure gradient and estimated RA pressure (eRAP), and then compared with directly measured PASP and RAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Estimated PASP was obtainable in 57% of subjects at rest, but feasibility decreased to 15\u201316% during exercise, due mainly to an inability to obtain eRAP during stress. Estimated PASP correlated well with direct PASP at rest (r=0.76, p&lt;0.0001; bias \u22121\u2005mmHg) and during exercise (r=0.76, p=0.001; bias +3\u2005mmHg). When assuming eRAP of 10\u2005mmHg, ePASP correlated with direct PASP (r=0.70, p&lt;0.0001), but substantially underestimated true values (bias +9\u2005mmHg), with the greatest underestimation among patients with severe exercise-induced pulmonary hypertension (EIPH). Estimation of eRAP during exercise from resting eRAP improved discrimination of patients with or without EIPH (area under the curve 0.81), with minimal bias (5\u2005mmHg), but wide limits of agreement (\u221214\u201325\u2005mmHg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RV\u2013RA pressure gradient can be estimated with reasonable accuracy during exercise when measurable. However, RA hypertension frequently develops in patients with EIPH, and the inability to noninvasively account for this leads to substantial underestimation of exercise pulmonary artery pressures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.01617-2019","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:25:11Z","timestamp":1574814311000},"page":"1901617","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":61,"title":["Noninvasive evaluation of pulmonary artery pressure during exercise: the importance of right atrial hypertension"],"prefix":"10.1183","volume":"55","author":[{"given":"Masaru","family":"Obokata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garvan C.","family":"Kane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemi","family":"Sorimachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh N.V.","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P.","family":"Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C.","family":"Egbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8921-7078","authenticated-orcid":false,"given":"Vojtech","family":"Melenovsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry A.","family":"Borlaug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2019,11,26]]},"reference":[{"key":"2024102101161663000_55.2.1901617.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.05.001"},{"key":"2024102101161663000_55.2.1901617.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.11.051"},{"key":"2024102101161663000_55.2.1901617.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.911818"},{"key":"2024102101161663000_55.2.1901617.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.085761"},{"key":"2024102101161663000_55.2.1901617.5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/nrcardio.2014.191","article-title":"Early detection of pulmonary arterial hypertension","volume":"12","author":"Lau","year":"2015","journal-title":"Nat Rev Cardiol"},{"key":"2024102101161663000_55.2.1901617.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031608"},{"key":"2024102101161663000_55.2.1901617.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000667"},{"key":"2024102101161663000_55.2.1901617.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.787101"},{"key":"2024102101161663000_55.2.1901617.9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.088427"},{"key":"2024102101161663000_55.2.1901617.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.220467"},{"key":"2024102101161663000_55.2.1901617.11","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.1093\/eurheartj\/ehy331","article-title":"Exercise unmasks distinct pathophysiologic features in heart failure with preserved ejection fraction and pulmonary vascular disease","volume":"39","author":"Gorter","year":"2018","journal-title":"Eur Heart J"},{"key":"2024102101161663000_55.2.1901617.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.12.024"},{"key":"2024102101161663000_55.2.1901617.13","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew190"},{"key":"2024102101161663000_55.2.1901617.14","doi-asserted-by":"crossref","first-page":"2874","DOI":"10.1093\/eurheartj\/ehx184","article-title":"Is it time to recognize a new phenotype? 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