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.