To the Editor: In their Grand Rounds article on pulmonary hypertension as a complication of hereditary hemolytic anemias, Dr Barnett and colleagues1 reported that the upper limit of normal for pulmonary arterial systolic pressure derived from the echocardiographic measurement of the tricuspid regurgitant jet velocity is less than 30 mm Hg. However, this limit does not apply to at least one-third of normal persons, particularly those who are older or obese, in whom the upper limit of normal is 40 mm Hg.2
Gnecchi-Ruscone T, Rigo F. Normal Range for Pulmonary Artery Systolic Pressure. JAMA. 2008;299(17):2022–2023. doi:10.1001/jama.299.17.2022-b
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