Wanessa Alves de Carvalho et al. Andressa Alves de Carvalho Eliauria Rosa Martins Agostinho Hermes de Medeiros Neto … Fernando Bacal Marcelo Dantas Tavares de Melo
Abstract
Background:
Considering that the effect of right ventricular (RV) failure on the right atrium (RA) is an essential part of the pathophysiology of pulmonary hypertension (PH), the assessment of RA function seems to have prognostic value in the course of the disease, but there are still few studies on this subject.
Objective:
To evaluate myocardial strain of the RA in patients with precapillary PH.
Methods:
This is an observational, longitudinal, prospective study involving 36 patients with precapillary PH, in whom two-dimensional Doppler echocardiography was performed. A control group consisting of 26 healthy individuals was used.
Results:
There was a statistically significant difference in mean RA strain between the group with PH (26.3%) and the control group (40.7%). Regarding RA strain of the patients, there was a negative and moderate correlation with RA pressure, RV diameter, and RV hypokinesia; negative and weak correlation with pulmonary artery systolic pressure (PASP); negative and strong correlation with RA area; and positive and moderate correlation with, tricuspid annular plane systolic excursion (TAPSE), TAPSE/PASP, and RV strain. Patients with RA strain ≤ 23 had significantly reduced overall survival compared with patients with RA strain > 23, but this value was not a predictor of mortality.
Conclusion:
It was possible to demonstrate that the analysis of myocardial strain of the RA provides more accurate information about RA function and can be used as an additional parameter in the follow-up of patients with PH, given the early evaluation of atrial dysfunction.