Pulmonary artery wedge pressure at rest and during exercise in healthy adults: a systematic review and meta-analysis.

BACKGROUND: The pulmonary artery wedge pressure (PAWP) response to exercise may unmask latent heart failure with preserved ejection fraction. There remains a lack of consensus over threshold values for PAWP during exercise. A systematic review of studies examining PAWP by right heart catheterization at rest and during exercise in healthy individuals was performed.

METHODS AND RESULTS: Relevant data derived from healthy volunteers were stratified by age (> or ≤40 years) and sex. Three exercise intensities were predefined: Light, Moderate, and Strenuous. Weighted means and weighted 95% confidence limits for the aggregate data were calculated. A total of 424 individuals from 32 unique studies were included, of which 19% (n=82) were female. PAWP reached weighted mean and 95% confident limit values of 19(17-21) and 17(16-18) mmHg at Light and Moderate exercise, respectively. The PAWP response to exercise was similar between men and women >40 years. However, exercise intensities were lower in women.

CONCLUSIONS: PAWP increases during exercise, reaching up to 20mmHg in adults >40 years. Older women achieve similar PAWP values as older men, but at lower intensities. Findings support a threshold of at least 25mmHg as an absolute cut-off value for 'normal' PAWP response to exercise in individuals >40 years.