Key result
Post-BPA right atrial reservoir strain ≥ 29.85% was independently associated with improved event-free survival for right heart failure hospitalization and all-cause death (P=0.012).
Why the study?
Pulmonary hypertension-induced right ventricular overload can result in right atrial remodeling and tricuspid regurgitation, negatively impacting prognosis, but the prognostic significance of right atrial function and tricuspid regurgitation in CTEPH patients needed clarification.
Does right atrial reservoir strain predict hospitalization for right heart failure and all-cause death in patients with CTEPH undergoing balloon pulmonary angioplasty?
Cohort (n=97)
Does right atrial reservoir strain predict hospitalization for right heart failure and all-cause death in patients with CTEPH undergoing balloon pulmonary angioplasty?
Post-BPA right atrial reservoir strain ≥ 29.85% is independently associated with improved long-term event-free survival in patients with CTEPH, highlighting the value of 2D-speckle tracking echocardiography for risk stratification.
RA reservoir strain may refine CTEPH risk stratification; leaves open its incremental value pending prospective validation.
OBJECTIVES: Pulmonary hypertension-induced right ventricular (RV) overload can result in right atrial (RA) remodeling and tricuspid regurgitation (TR), which in turn affects RV function and negatively impacts patient prognosis. This study aimed to clarify the prognostic significance of RA function and TR in patients with chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: For this retrospective analysis of 97 patients with CTEPH who underwent balloon pulmonary angioplasty (BPA), clinical, hemodynamic, and echocardiographic data were acquired before the first BPA and after the final BPA. The composite end point was hospitalization due to right heart failure and all-cause death. RESULTS: After BPA, patients experienced significant increases in RA reservoir strain (RASr, 26.7 ± 9.1% vs. 35.2 ± 11.3%, P<.001) and conduit strain (15.0[9.6] % vs. 22.6[9.6] %, P<.001), with no significant change in RA contraction strain. TR was significantly improved after BPA, decreasing from 49.5% to 22.7% in patients with significant TR (P<.001). Over a mean follow-up of 24.7 ± 12.4 months, 22 patients met the composite end point. On multivariate Cox regression analysis, Right atrial reservoir strain (RASr) was independently associated with composite clinical outcomes(P=.012). Patients with post-BPA RASr ≥ 29.85% exhibited superior event-free survival compared to those with lower values. CONCLUSION: Right atrial reservoir and conduit functions were impaired in CTEPH patients and showed significant improvement following BPA. Post-BPA RASr ≥ 29.85% demonstrated an independent association with long-term clinical outcomes. These findings support the inclusion of RA strain in postoperative assessments and long-term follow-up of CTEPH patients treated with BPA. CLINICAL RELEVANCE STATEMENT: In this study, 2D-speckle tracking echocardiography can be used to better monitor right heart status of patients. To some extent, it can help clinicians to provide better treatment for patients and improve the quality of life of patients.
No takes yet. Share an insight, caveat, or question.
Ma et al. (2026) conducted a cohort in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=97). Balloon pulmonary angioplasty (BPA) and echocardiographic assessment was evaluated on Hospitalization due to right heart failure and all-cause death (p=.012). Post-BPA right atrial reservoir strain ≥ 29.85% was independently associated with improved event-free survival for right heart failure hospitalization and all-cause death (P=0.012).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: