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Right Atrial Strain in Pediatric Pulmonary Hypertension-A Prospective Observational Study
Subhrashis Guha Niyogi1, Avneet Singh2, Bhupesh Kumar3
1Department of Anaesthesia, All India Institute of Medical Sciences, Kalyani, West Bengal, India.
Pediatric Cardiology
|May 22, 2024
Summary
Right atrial strain effectively estimates pulmonary arterial pressure in children with congenital heart disease-associated pulmonary hypertension. This method shows promise for assessing pulmonary hypertension and predicting outcomes in pediatric patients.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Echocardiography
Background:
- Pulmonary hypertension (PH) leads to right atrial (RA) remodeling and dysfunction.
- RA function correlates with pulmonary arterial (PA) pressures and outcomes in PH patients.
- Assessing PA pressures is crucial for managing PH in congenital heart disease (CHD).
Purpose of the Study:
- To investigate the utility of RA strain in estimating PA pressures in pediatric patients with CHD-associated PH.
- To evaluate the correlation between RA strain parameters and invasive PA pressure measurements.
- To determine if RA strain can predict postoperative PH and prognosis.
Main Methods:
- Transthoracic echocardiography was used to measure RA reservoir, conduit, and contractile strain in children under 12 years old with CHD and PH.
- Measurements were taken after anesthesia induction, with pre- and post-repair invasive PA pressures recorded.
- Conventional measures of right ventricular (RV) function and PA pressure were also assessed.
Main Results:
- Contractile RA strain demonstrated a significant correlation with pre-repair systolic PA pressure (r=0.59) and as a percentage of SBP (r=0.67).
- RA strain predicted persistent postoperative PH, similar to pulmonary artery acceleration time and RV systolic pressure.
- These findings suggest RA strain is a valuable echocardiographic marker in pediatric PH.
Conclusions:
- RA strain is a reliable echocardiographic tool for estimating PA pressures in children with CHD-associated PH.
- RA strain shows potential prognostic value and aids in the echocardiographic assessment of pediatric PH.
- Further research in larger cohorts is warranted to confirm these findings.
