title: Evaluation of right atrial function using right atrial speckle tracking analysis in patients with pulmonary artery hypertension.
abstract: BACKGROUND
  In patients with pulmonary artery hypertension (PAH), right ventricular pressure overload eventually causes right heart failure (RHF), leading to a poor prognosis. Right atrial (RA) overload and RA dysfunction occur in patients with PAH-complicated RHF.
  
  
  OBJECTIVE
  We evaluated RA function using right atrial longitudinal strain (RALS) by two-dimensional speckle tracking echocardiography (2D-STE) and investigated the association between RALS and the severity of RHF in patients with pulmonary artery hypertension (PAH) noninvasively.
  
  
  METHODS
  We performed 2D-STE in 56 PAH patients and 20 normal control subjects. The peak global RALS and peak global RA longitudinal strain rate (RALSR) were analyzed by 2D-STE. Simultaneous right heart catheterization was performed to determine the right atrial pressure (RAP) and cardiac index (CI).
  
  
  RESULTS
  Peak global RALS (34.6 ± 14.1 vs. 58.3 ± 9.9%, p < 0.0001) and peak global RALSR (2.5 ± 1.3 vs. 3.1 ± 1.2 s(-1), p < 0.0001) were significantly lower in PAH patients compared with normal controls. There was a significant negative correlation between peak global RALS and RAP (r = -0.8037, p < 0.0001). There was a significant positive correlation between peak global RALS and CI (r = 0.8179, p < 0.0001). Peak global RALSR was also correlated with RAP (r = -0.7308, p < 0.0001) and CI (r = 0.7596, p < 0.0001).
  
  
  CONCLUSIONS
  RALS and RALSR by 2D-STE were useful for noninvasive evaluation of RA dysfunction and the severity of RHF in patients with PAH.
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. konomi@db3.so-net.ne.jp.
authors.forename: Konomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Uesugi
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Isaka
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Minamishima
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.affiliation: Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
mesh_terms: D016275:Atrial Function; D016280:Atrial Function, Right; D062185:Atrial Pressure; D006328:Cardiac Catheterization / Q000009:adverse effects; D016022:Case-Control Studies; D006325:Heart Atria; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D011651:Pulmonary Artery; D018497:Ventricular Dysfunction, Right; D016278:Ventricular Function, Right
keywords: Pulmonary artery hypertension; Right atrial function; Right atrial strain; Speckle tracking imaging