Journal article

Publication year: 2023

Journal: The Journal of Heart and Lung Transplantation

Volume number: 42

Issue number: 4

ISSN: 1053-2498

eISSN: 1557-3117

DOI Link: https://doi.org/10.1016/j.healun.2022.11.007

Publisher: Elsevier

Abstract: 
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 univari-able 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 arte-rial 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 differ-ent acquisition methods.J Heart Lung Transplant 2023;42:433-446 (c) 2022 International Society for Heart and Lung Transplantation. All rights reserved.

Harvard Citation style: Richter, M., Fortuni, F., Alenezi, F., D'Alto, M., Badagliacca, R., Brunner, N., et al. (2023) Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis, The Journal of Heart and Lung Transplantation, 42(4). https://doi.org/10.1016/j.healun.2022.11.007

APA Citation style: Richter, M., Fortuni, F., Alenezi, F., D'Alto, M., Badagliacca, R., Brunner, N., Dijk, A., Douschan, P., Gall, H., Ghio, S., Lo Giudice, F., Grunig, E., Haddad, F., Howard, L., Rajagopal, S., Stens, N., Stolfo, D., Thijssen, D., Vizza, C., ...Tello, K. (2023). Imaging the right atrium in pulmonary hypertension: A systematic review and meta-analysis. The Journal of Heart and Lung Transplantation. 42(4). https://doi.org/10.1016/j.healun.2022.11.007