Clinical utility of right atrial strain to estimate pulmonary hypertension in comparison with right ventricular free wall longitudinal strain.

Objectives: This study aimed to measure right atrial (RA) strain in the reservoir, conduit, and contraction phases and examine its clinical utility in detecting pulmonary hypertension (PH).

Methods: One hundred and thirteen patients hospitalized in the intensive or coronary care units of our institution who underwent echocardiography and measurements of RA/right ventricular (RV) strain were retrospectively examined. RA strain was measured in the reservoir, conduit, and contraction phases of one cardiac cycle. PH was defined as peak tricuspid regurgitation velocity >2.8 m/s. Patients were grouped according to PH status (PH, no PH) and statistically compared. Logistic regression and receiver operating characteristic analyses were also performed.

Results: Mean age was 71.1±15.4 years and 72 were men (63.7%). The PH and no PH groups comprised 40 and 73 patients, respectively. Among the RA strain parameters, RA strain in the conduit phase was significantly lower in the PH group (-8.1±4.2% vs. -17.4±7.7%; p<0.001). In the receiver operating characteristic analysis for PH, RA strain in the conduit phase had the highest area under the curve among the RA/RV strain parameters (area under the curve, 0.88; sensitivity, 92.5%; specificity, 71.2%; p<0.001).

Conclusions: RA strain is an echocardiographic parameter that can detect PH and should be considered when RV strain parameters are not measurable.