Right atrial strain: new predictor of future HF-related events in patients with acute decompensated heart failure?
M Samos, J Jurica, M J Pec, T Bolek, M Cingel, B Focko, M MokanAbstract
Background
There are minimal data about the predictive value of impaired right atrial (RA) strain (RAS) or right atrial cardiopathy in patients with acute decompensated heart failure (ADHF), especially with regard to heart failure (HF)-related adverse events (cardiovascular death, HF-related hospitalizations). Therefore, the prognostic value of RAS in ADHF needs to be studied more extensively.
Purpose
The aim of this study was to assess the predictive value of the RAS (reservoir-R, conduit-CD, contraction-CT) for future HF-related events in patients with ADHF.
Methods
This study enrolled eighteen patients admitted to our ward for ADHF. Transthoracic echocardiography (TTE) with two-dimensional speckle tracking analysis (2D ST) was performed in each patient. For RAS analysis, left-atrial strain dedicated commercially available software was used (off-label; as there was no dedicated software available). RA free wall was traced as septal and septal wall was traced as left atrial free wall, RA contours were adjusted manually if needed, and RAS was automatically assessed by the software. HF patients were followed for 12-months for HF-related adverse events (cardiovascular death or HF-related hospitalisation).
Results
The observed values of R-RAS in ADHF patients were 10.1±5.5%, of CD-RAS were -8.1±4.5%, and of CT-RAS were -2.1±1.0%, respectively. In the adverse event analysis, impaired R-RAS (less positive) and CD-RAS (less negative) predicted a major cardiovascular event in a 6-month and 12-month follow-up period.
Conclusion
Our study, impaired RAS predicted adverse events in a 6-month and 12-month follow-up period. These observations support the future research on the possible role of right atrial dysfunction for predicting un-favourable course of HF.