Pulmonary Artery Systolic Pressure is Elevated in the Elderly : Relationships between Echocardiographic and Pathological Findings

Objective  We investigated the relationship between the right cardiac system and increased pulmonary artery systolic pressure (PASP) in the elderly.  Patients and Methods  Echocardiography stable state data were available for 163 of 200 consecutive autopsied patients. Of these, PASP could be estimated by extrapolation from the maximum pressure gradient in tricuspid valve regurgitation from echocardiograms in 73 cases; however, 22 cases with secondary changes attributable to left cardiac insufficiency had to be excluded. We studied the remaining 51 patients in detail (16 men, 35 women, age 68-103 years; mean, 87.7±8.1). We investigated the following: echocardiographic and pathologic variables, age, sex, body mass index, the survival time (from echocardiography to autopsy), and the presence or absence of chronic pulmonary disease.  Results  The average PASP was 39.8±10.3 mmHg, elevated compared with young persons. Linear regression analysis showed a close correlation of PASP with age (r=0.35, p=0.011), thickness of the right ventricle (RV) outflow tract wall as an index of RV hypertrophy (r=0.35, p=0.013) and the survival time (r=−0.36, p=0.0083). By multiple regression analysis, PASP was correlated with the thickness of RV outflow tract (p=0.0037) even after adjustment for other factors including chronic pulmonary disease.  Conclusions  PASP is elevated in the elderly and it is correlated with the thickness of the RV outflow tract wall as an index of RV hypertrophy.