Behavior of right atrial strain in high systolic pulmonary artery pressure

Aims Evaluate the ability of right atrial ( RA ) strain to predict systolic pulmonary artery pressure ( SPAP ). Methods and Results A total of 102 patients were prospectively enrolled. Conventional echocardiographic measures were performed. RA volume was calculated. Mean maximum right ventricle ( RV ) strain and lateral RA strain were obtained. Pearson's correlation test was used. A multivariate analysis was performed to compare SPAP with RA strain, RV strain, and baseline characteristics of the patients. RA strain was compared between patients with SPAP  ≤ 37 mm Hg with those with SPAP  > 37 mm Hg. A receiver operating characteristic ( ROC ) curve was constructed. A P  < 0.01 value was considered statistically significant. Age 58.7 ± 15.7 years. Male: 46 (45.1%). The correlation coefficient between SPAP and RA strain was −0.64 ( P  < 0.01, 95% confidence interval ( CI ): −0.75 to −0.50). Quadratic R2 coefficient = 0.52. In the multivariate analysis, RA strain was independently associated with SPAP level. There were significant differences in RA strain between patients with SPAP  ≤ 37 mm Hg (63.3 ± 13.3%; 95% CI : 59.4%–65.1%) and >37 mm Hg (32.7 ± 11.1%; 95% CI : 26.5%–38.39%) ( P  < 0.01). RA strain < 42.5% was capable to predict a SPAP  > 37 mm Hg with 93% sensitivity and 94% specificity, area under the curve ( AUC ) of 98% (95% CI : 94%–100%). Conclusions Right atrial strain is independently associated with SPAP level. RA strain lower than 42.5% can predict a SPAP  > 37 mm Hg with high sensitivity and specificity.