['Transthoracic echocardiographic estimates of peak systolic pulmonary artery pressure are conventionally calculated from the maximal velocity of the tricuspid regurgitation (TR) jet. Unfortunately, there is insufficient TR to determine estimated peak systolic pulmonary artery pressure (EPSPAP) in a significant number of patients. To date, in the absence of TR, no noninvasive method of deriving EPSPAP has been developed.', 'Five hundred clinically indicated transthoracic echocardiograms were reviewed over a period of 6 months. Patients with pulmonic stenosis were excluded. Pulsed-wave Doppler was used to measure pulmonary artery acceleration time (PAAT) and right ventricular ejection time. Continuous-wave Doppler was used to measure the peak velocity of TR (TR(Vmax)), and EPSPAP was calculated as 4 × TR(Vmax)(2)\xa0+ 10 mm Hg (to account for right atrial pressure). The relationship between PAAT and EPSPAP was then assessed.', 'Adequate imaging to measure PAAT was available in 99.6% of patients (498 of 500), but 25.3% (126 of 498) had insufficient TR to determine EPSPAP, and 1 patient had significant pulmonic stenosis. Therefore, 371 were included in the final analysis. Interobserver variability for PAAT was 0.97. There were strong inverse correlations between PAAT and TR(Vmax) (r\xa0= -0.96), the right atrial/right ventricular pressure gradient (r\xa0= -0.95), and EPSPAP (r\xa0= -0.95). The regression equation describing the relationship between PAAT and EPSPAP was log(10)(EPSPAP)\xa0= -0.004 (PAAT)\xa0+ 2.1 (P < .001).'] Does pulmonary artery acceleration time provide an accurate estimate of systolic pulmonary arterial pressure during transthoracic echocardiography?