Strong negative correlation between estimated pulmonary artery systolic pressure and right atrial strain

Abstract

Background: Echocardiography is used to assess pulmonary artery pressure, but the magnitude of tricuspid regurgitation is a limiting factor. Objectives: The aim of this study was to evaluate the correlation between estimated pulmonary artery systolic pressure and right atrial strain. Methods: A total of 40 patients with sinus rhythm and adequate tricuspid regurgitation were included. Tricuspid annular plane systolic excursion, the velocity of this excursion, right ventricular dimension and right atrial volume were determined. Peak right atrial basal strain and mid-lateral strain during the reservoir phase were averaged. Right atrial strain was compared in patients with estimated pulmonary artery systolic pressure <36 mmHg and ≥36 mmHg using Student’s t test. Pearson’s correlation coefficient was calculated between right atrial strain and estimated pulmonary artery systolic pressure using the bootstrapping method to evaluate the corresponding confidence interval. Results: Mean age was 59±11 years and 45% were men. There were statistically significant differences in right atrial strain between patients with estimated pulmonary artery systolic pressure <36 mmHg and ≥36 mmHg (69.92±11.69 vs. 29.40±11.06; p=0.001; 95% CI: -53.93- -27.09). The correlation between estimated pulmonary artery systolic pressure and right atrial strain was -0.87 (p <0.01; 95% CI: -0.72- -0.93). The correlation coefficient was positive but weaker between estimated pulmonary artery systolic pressure, right atrial volume (r=0.67) and right ventricular dimension (r=0.59). Conclusions: The results show a strong negative correlation between estimated pulmonary artery systolic pressure and right atrial strain which could be useful when tricuspid regurgitation is absent.