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Published on: July 20, 2022
Prognostic Value of Right Atrial Analysis in Patients With Nonischemic Cardiomyopathy
Jordi Lozano-Torres1, Eduard Ródenas-Alesina2, Pablo Eduardo Tobías-Castillo1
1Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Cardiovascular Diseases, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
In nonischemic cardiomyopathy, larger right atrial volume index (RAVI) predicts major adverse cardiovascular events. Peak right atrial strain (PRAS) adds value to RAVI for risk assessment in these patients.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Right ventricular (RV) dysfunction impacts prognosis in nonischemic cardiomyopathy (NICM).
- Evaluating RV function can be challenging.
- Right atrial volume index (RAVI) and peak right atrial strain (PRAS) may indicate RV diastolic dysfunction, but their prognostic value in NICM is unclear.
Purpose of the Study:
- To assess the predictive value of RAVI and PRAS for cardiovascular mortality or heart failure hospitalization in NICM patients.
- To determine if right atrial strain parameters can identify high-risk individuals within the NICM population.
Main Methods:
- Retrospective, single-center, observational, longitudinal study.
- Included NICM patients with left ventricular ejection fraction <50% and no coronary disease.
- Primary endpoint: Major Adverse Cardiovascular Events (MACE), defined as heart failure hospitalization or cardiovascular death.
Main Results:
- 134 out of 512 patients (26.2%) experienced MACE during 3.4 years of follow-up.
- Increased RAVI and decreased PRAS were independently associated with MACE.
- RAVI and PRAS demonstrated additive value in predicting MACE.
Conclusions:
- A larger RAVI is a significant predictor of adverse cardiovascular outcomes in NICM patients.
- PRAS offers complementary prognostic information when used with RAVI for MACE risk stratification in NICM.
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