In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Right atrial function and prognosis in pulmonary arterial hypertension

Session CTEPH: Catheter-directed and surgical therapy

Speaker Michele D'Alto

Event : ESC Congress 2017

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Pulmonary Hypertension
  • Session type : Moderated Posters

Authors : M D'alto (Naples,IT), A D'andrea (Naples,IT), G Di Salvo (London,GB), G Scognamiglio (Naples,IT), P Argiento (Naples,IT), E Romeo (Naples,IT), GM Di Marco (Naples,IT), A Mattera Iacono (Naples,IT), B Sarubbi (Naples,IT), MG Russo (Naples,IT)

Authors:
M. D'Alto1 , A. D'Andrea1 , G. Di Salvo2 , G. Scognamiglio1 , P. Argiento1 , E. Romeo1 , G.M. Di Marco1 , A. Mattera Iacono1 , B. Sarubbi1 , M.G. Russo1 , 1Second University of Naples - Monaldi Hospital, Department of Cardiology - Naples - Italy , 2Royal Brompton Hospital, Paediatric Cardiology - London - United Kingdom ,

Topic(s):
Chronic pulmonary hypertension

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 835

Aims: To determine whether right atrial (RA) function has prognostic value in patients with pulmonary arterial hypertension (PAH).

Methods and results: Overall, 118 patients (79 female, mean age 58±13 years) with PAH underwent standard Doppler echocardiography and strain and strain rate (SR) analysis before right heart catheterization. At a mean follow-up of 19±4 months, 34 patients (29%) had clinical worsening. On Cox's multivariable proportional-hazards regression analysis, RA reservoir function (hazard ratio [HR] 0.5; P<0.0001), RA area (HR 1.2; P<0.01), right ventricular (RV) SR (HR 0.6; P<0.0001), cardiac index (HR 0.79; P<0.01), and PaO2 (HR 0.82; P<0.01) were found to be independent correlates of cardiac events. A RA reservoir cut-off value of <1.2 ms and a RV SR cut-off value of <1% well identified patients at higher risk of clinical worsening (85.5% sensitivity; 90.4% specificity; test accuracy: 88.8%). In particular, event rates and mean survival time free of clinical worsening were: 6.1% and 23.5±2.2 months in patients with normal RA and RV strain; 45% and 20.9±5.5 months in patients with impaired RA strain and normal RV SR; 56.2% and 17.7±6.6 months in patients with normal RV SR and impaired RA strain; and 87.5% and 12.9±7.6 months in patients with impairment of both RA strain and RV SR.

Conclusion: Our data suggest that RA function has prognostic value in PAH, where a poorer RA function, as explored by strain and SR analysis, is associated with a worse outcome.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now
logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are