Pulmonary Artery Pulsatility Index (PAPi)
Pulmonary artery pulse pressure relative to right atrial pressure
Version 1.0.0
Haemodynamic measurements
Enter pressures measured in the same unit. The supported range is based on the source calculator.
PA systolic pressure
mmHg
PA diastolic pressure
mmHg
Right atrial pressure (CVP)
mmHg
PAPi
—
Context-specific interpretation
Lower PAPi values generally indicate worse right-ventricular–pulmonary-vascular coupling, but no single normal/abnormal threshold applies across populations and haemodynamic conditions.
- Acute inferior myocardial infarction with suspected right ventricular dysfunction: PAPi ≤0.9 identified a high-risk population in Korabathina et al.
- Left ventricular assist device candidates: PAPi <1.85 predicted postoperative right ventricular failure in Kang et al.
No clinical values are intentionally saved by this control.
Equations
Pulmonary artery pulsatility index
PAPi = (PASP - PADP) / RAPPASP is pulmonary artery systolic pressure, PADP is pulmonary artery diastolic pressure, and RAP is right atrial pressure (central venous pressure, CVP). All three pressures must use compatible units. PAPi is dimensionless. RAP must be greater than zero and PASP must be greater than or equal to PADP.
References
- Korabathina R, Heffernan KS, Paruchuri V, Patel AR, Mudd JO, Prutkin JM, et al. The pulmonary artery pulsatility index identifies severe right ventricular dysfunction in acute inferior myocardial infarction. Catheter Cardiovasc Interv. 2012;80(4):593-600. PMID: 21954053 DOI: 10.1002/ccd.23309
- Kang G, Ha R, Banerjee D. Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation. J Heart Lung Transplant. 2016;35(1):67-73. PMID: 26212656 DOI: 10.1016/j.healun.2015.06.009
- Essandoh M, Kumar N, Walunj A, Kormos RL, Akin S, Samy K, et al. Pulmonary artery pulsatility index and right ventricular failure after left ventricular assist device implantation: a systematic review. J Heart Lung Transplant. 2022;41(8):1114-1123. PMID: 35644726 DOI: 10.1016/j.healun.2022.04.007
- Yim IHW, Kittipibul V, Kfoury AG, Fang JC, DeVore AD, Hsu S, et al. A systematic review and physiology of pulmonary artery pulsatility index in left ventricular assist device therapy. ESC Heart Fail. 2023;10(4):2111-2121. PMID: 37171900