Deschle Héctor A, Amenabar Agustina, Casso Norberto A, Gantesti Jessica, Carnevalini Mariana, Alfie Laura, Torres Bianqui Carolina, Ottonello Pablo, Katib Maria Cristina
Echocardiography Section, Diagnóstico Maipú, Vicente Lopez, Buenos Aires, Argentina.
Echocardiography. 2018 Oct;35(10):1557-1563. doi: 10.1111/echo.14102. Epub 2018 Jul 25.
Evaluate the ability of right atrial (RA) strain to predict systolic pulmonary artery pressure (SPAP).
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%).
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.
评估右心房（RA）应变预测收缩期肺动脉压（SPAP）的能力。
前瞻性纳入102例患者。进行常规超声心动图测量。计算RA容积。获得平均最大右心室（RV）应变和右心房侧壁应变。采用Pearson相关检验。进行多因素分析以比较SPAP与RA应变、RV应变及患者的基线特征。比较SPAP≤37mmHg的患者与SPAP>37mmHg的患者之间的RA应变。构建受试者工作特征（ROC）曲线。P<0.01被认为具有统计学意义。年龄：58.7±15.7岁。男性：46例（45.1%）。SPAP与RA应变的相关系数为-0.64（P<0.01，95%置信区间（CI）：-0.75至-0.50）。二次R2系数=0.52。在多因素分析中，RA应变与SPAP水平独立相关。SPAP≤37mmHg的患者（63.3±13.3%；95%CI：59.4%-65.1%）与SPAP>37mmHg的患者（32.7±11.1%；95%CI：26.5%-38.39%）之间的RA应变存在显著差异（P<0.01）。RA应变<42.5%能够以93%的敏感性和94%的特异性预测SPAP>37mmHg，曲线下面积（AUC）为98%（95%CI：94%-100%）。
右心房应变与SPAP水平独立相关。低于42.5%的RA应变能够以高敏感性和特异性预测SPAP>37mmHg。
