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Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Right atrial strain by speckle-tracking echocardiography as a prognostic predictor in a pulmonary hypertension cohort
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
João Pedro Dias Ferreira Reis
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
João Pedro Reis; Marta Nogueira; Lídia Sousa; Luísa Branco; Ana Galrinho; Rui Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Background: Right atrial (RA) strain is a promising technique for the assessment of RA function and several studies have suggested it is a powerful prognostic marker in pulmonary hypertension (PH) patients (pts). Our aim was to assess the prognostic power of the RA strain in Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) pts.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Methods: Pts with PH were prospectively studied and several clinical/demographic/echocardiographic were retrieved as well as data from six-minute walk test (6MWT) and brain natriuretic peptide (BNP). Correlation between RA strain and other variables was tested with Pearson's correlation analysis. Regression and survival analysis was performed to assess the combined endpoint of all-cause mortality or hospitalization in the first follow-up year (MH<sub>1</sub>).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Results: A total of 51 PH pts (mean age 54±46 years, 33.3% male, baseline BNP of 342.4±439.9pg/mL and baseline pulmonary artery systolic pressure – PASP - of 78±26mmHg), of which 64.7% had PAH and 35.3% presented CTEPH. 19 ots (37.3%) met the primary endpoint. The mean RA strain was -21.9 ± -4.9%, with no significant difference between groups (-23.4% vs -17.8%, <em>p</em> = 0.150), however male pts had a significantly lower RA strain (-15.9% vs -25.1%, <em>p</em> = 0.014). There was a statistically significant (<em>p</em> < 0.05) correlation between RA strain and age (r = -0.287), indexed RA area (-0.539), index RA volume ( -0.522) and right ventricular strain ( -0.453). There was no correlation between RA strain and BNP value (<em>p </em>= 0.150), 6MWT distance (<em>p </em>= 0.145) or PASP (<em>p </em>= 0.072). RA strain was a predictor of MH<sub>1</sub> (OR = 0.94, 95% CI: 0.894-0.998, <em>p </em>= 0.048). Pts who met the primary endpoint had a significantly lower RA strain (-17.0 vs -24.6%, <em>p </em>= 0.032). Those with a RA strain below -19% presented a significantly lower free of events during the first follow-up year (log rank <em>p</em> = 0.022).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Conclusion: RA strain is a powerful predictor of adverse events in a PH population and should be systematically assessed in order to improve risk stratification. </span></span></span></span></p>
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