The correlation of right heart functional classification with right atrial deformation in patients with pulmonary arterial hypertension:a study with two-dimensional speckle tracking imaging / 中华超声影像学杂志

ABSTRACT

Objective To assess right atrial (RA)myocardial mechanics in pulmonary hypertension (PH ) patients using two-dimensional speckle tracking imaging (2D-STI ),and define the relationship between RA function and exercise capacity in PH patients.Methods Thirty-eight consecutive PH patients were studied and compared with a control group of 25 healthy volunteers.Peak atrial longitudinal strain (PALS)and strain rate of RA were measured in all subjects.PALS values were obtained by averaging all segments (global PALS)measured in the 4-chamber view.Results RA PALS was significantly lower in PH patients than in controls,and gradually reduced with the development of cardiac insufficiency.A significantly postive correlation between global PALS and 6-minute walk distance was found(P =0.003). Furthermore,global PALS demonstrated the highest diagnositic accuracy (AUC of 0.979 )and excellent sensitivity and specificity of 86.8% and 84.0%,respectively,to predict functional status using a cutoff value less than 38.08%.Conclusions RA deformation is significantly damaged in PH patients.RA reservoir function can be estimated using 2D-STI,and gradually decrease in PH patients with different WHO-functional class (WHO-FC).RA PALS is a powerful predictor of cardiac functional status and exercise capacity in PH patients.