Right Atrium Volume Index in Patients with Secondary Pulmonary Hypertension Due to Chronic Obstructive Pulmonary Disease.
BACKGROUND
Right atrium volume index has recently been described as a quantitative and highly reproducible echocardiographic parameter associated with right ventricle systolic dysfunction in patients with chronic systolic heart failure. The aim of the current study was to assess right atrium remodeling and to establish correlations with echocardiographic parameters of right ventricle systolic and diastolic dysfunction in patients with pulmonary hypertension due to chronic obstructive pulmonary disease (COPD).


METHODS
The study was conducted on 40 patients with secondary pulmonary hypertension due to COPD and 40 healthy volunteers (mean age 59 ± 6 years) who submitted to detailed echocardiographic examinations. Plasma levels of the soluble interleukin-1 receptor family member, N-terminal pro-B type natriuretic peptide and galectin-3 were measured in both groups.


RESULTS
The right atrium volume index was significantly higher in the test group (45.7 ± 15.3 vs. 25.4 ± 4.0 mL/m(2)) and showed strong correlations to tricuspid annular plane systolic excursion (r = -0.733, p < 0.0001), right ventricle fractional area change (r = -0.662, p < 0.0001), right ventricle ejection fraction (r = -0.741, p < 0.0001), and systolic pulmonary artery pressures (r = 0.721, p < 0.0001). Multivariate analysis facilitated the construction of a linear regression model which showed that right ventricle systolic dysfunction parameters (R(2)-adjusted = 0.62, p < 0.001), elevated systolic pulmonary artery pressure (R(2)-adjusted = 0.52, p < 0.001) and heart failure biomarkers (log-transformed sST2, galectin-3 and N-terminal pro-B type natriuretic peptide) (R(2)-adjusted = 0.41, p < 0.001) were independently associated with right atrium volume index.


CONCLUSIONS
Right ventricle systolic dysfunction and elevated systolic pulmonary artery pressure are independently associated with right atrium volume index in patients with pulmonary hypertension due to COPD.


BACKGROUND
Echocardiography; Right atrium volume index; Right ventricular diastolic function; Right ventricular systolic function.
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Lucia
L
Agoston-Coldea
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Dana
D
Petrovai
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Isabella
I
Mihalcea
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Radu
R
Revnic
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Teodora
T
Mocan
Department of Cardiovascular Disease and Transplant Institute, University of Medicine and Pharmacy of Targu Mures, Romania.
Silvia
S
Lupu