Right atrial and right ventricular strain in patients with acute decompensated heart failure: a pilot study

The aim of this study was to compare the right atrial (RAS: reservoir-R, conduit-CD, contraction-CT) and right ventricular strain (global longitudinal-RV-GS, free wall strain-RV-FWS) between patients with acute decompensation of chronic heart failure (ADHF) and a control group.

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. The cut-off value of ≤40% was used to distinguish HF with reduced (HFrEF) from HF with preserved ejection fraction (HFpEF). The control group consisted of eighteen healthy individuals with no known history of cardiovascular disease. HF patients were followed for 6-months for HF-related adverse events (cardiovascular death or HF-related hospitalisation).

We found that RV-GS and RV-FWS were significantly lower in ADHF in comparison with the control group (RV-GS: -15.7 ± 3.32% vs. -22.6 ± 2.26%, p < 0.001; RV-FWS: -19.2 ± 4.7% vs. -25.9 ± 2.54%, p < 0.001). There was no significant difference in RV-GS and RV-FWS between the HFrEF and HFpEF subgroups. Additionally, R-RAS, CD-RAS and CT-RAS were significantly changed in HF patients compared to controls (R-RAS: 10.1 ± 5.5% vs. 42.5 ± 11.8%, p < 0.001; CD-RAS -8.1 ± 4.5% vs. -27.5 ± 9.3%, p < 0.001; CT-RAS: -2.1 ± 1.0% vs. -14.3 ± 6.1%, p < 0.001), and predicted major cardiovascular event in a 6-month follow-up period.

Our study demonstrated a significant difference in RAS, RV-GS and RV-FWS in patients with acute decompensation of HF in comparison with the control group, with no significant difference between the HFrEF and HFpEF subgroups. RAS predicted adverse events in a 6-month follow-up period.