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Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis.

Publication ,  Journal Article
Richter, MJ; Fortuni, F; Alenezi, F; D'Alto, M; Badagliacca, R; Brunner, NW; van Dijk, AP; Douschan, P; Gall, H; Ghio, S; Giudice, FL ...
Published in: J Heart Lung Transplant
April 2023

BACKGROUND: Right atrial (RA) imaging has emerged as a promising tool for the evaluation of patients with pulmonary hypertension (PH), albeit without systematic validation. METHODS: PubMed, Web of Science and the Cochrane library were searched for studies investigating the prognostic value of RA imaging assessment in patients with PH from 2000 to June 2021 (PROSPERO Identifier: CRD42020212850). An inverse variance-weighted meta-analysis of univariable hazard ratios (HRs) was performed using a random effects model. RESULTS: Thirty-five studies were included (3,476 patients with PH; 74% female, 86% pulmonary arterial hypertension). Risk of bias was low/moderate (Quality of Prognosis Studies checklist). RA area (HR 1.06; 95% confidence interval [CI] 1.04-1.08), RA indexed area (HR 1.09; 95% CI 1.04-1.14), RA peak longitudinal strain (PLS; HR 0.94; 95% CI 0.91-0.97) and RA total emptying fraction (HR 0.96; 95% CI 0.94-0.98) were significantly associated with combined end-points including death, clinical worsening and/or lung transplantation; RA volume and volume index showed marginal significant associations. RA area (HR 1.06; 95% CI 1.04-1.07), RA indexed area (HR 1.12; 95% CI 1.07-1.17) and RA PLS (HR 0.98; 95% CI 0.97-0.99) showed significant associations with mortality; RA total emptying fraction showed a marginal association. CONCLUSIONS: Imaging-based RA assessment qualifies as a relevant prognostic marker in PH. RA area reliably predicts composite end-points and mortality, which underscores its clinical utility. RA PLS emerged as a promising imaging measure, but is currently limited by the number of studies and different acquisition methods.

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Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

April 2023

Volume

42

Issue

4

Start / End Page

433 / 446

Location

United States

Related Subject Headings

  • Surgery
  • Prognosis
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Heart Atria
  • Female
  • Echocardiography
  • Atrial Appendage
  • 3202 Clinical sciences
 

Citation

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ICMJE
MLA
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Richter, M. J., Fortuni, F., Alenezi, F., D’Alto, M., Badagliacca, R., Brunner, N. W., … Tello, K. (2023). Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis. J Heart Lung Transplant, 42(4), 433–446. https://doi.org/10.1016/j.healun.2022.11.007
Richter, Manuel J., Federico Fortuni, Fawaz Alenezi, Michele D’Alto, Roberto Badagliacca, Nathan W. Brunner, Arie P. van Dijk, et al. “Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis.J Heart Lung Transplant 42, no. 4 (April 2023): 433–46. https://doi.org/10.1016/j.healun.2022.11.007.
Richter MJ, Fortuni F, Alenezi F, D’Alto M, Badagliacca R, Brunner NW, et al. Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis. J Heart Lung Transplant. 2023 Apr;42(4):433–46.
Richter, Manuel J., et al. “Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis.J Heart Lung Transplant, vol. 42, no. 4, Apr. 2023, pp. 433–46. Pubmed, doi:10.1016/j.healun.2022.11.007.
Richter MJ, Fortuni F, Alenezi F, D’Alto M, Badagliacca R, Brunner NW, van Dijk AP, Douschan P, Gall H, Ghio S, Giudice FL, Grünig E, Haddad F, Howard L, Rajagopal S, Stens N, Stolfo D, Thijssen DHJ, Vizza CD, Zamanian RT, Zhong L, Seeger W, Ghofrani HA, Tello K. Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis. J Heart Lung Transplant. 2023 Apr;42(4):433–446.
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

April 2023

Volume

42

Issue

4

Start / End Page

433 / 446

Location

United States

Related Subject Headings

  • Surgery
  • Prognosis
  • Male
  • Hypertension, Pulmonary
  • Humans
  • Heart Atria
  • Female
  • Echocardiography
  • Atrial Appendage
  • 3202 Clinical sciences