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Comparative Study
. 2025 Aug;44(8):1343-1347.
doi: 10.1016/j.healun.2025.03.009. Epub 2025 Mar 20.

Comparison of the prognostic value of right atrial echocardiographic parameters in pulmonary arterial hypertension

Danny Mohama  1 , Pitchaya Worapongsatitaya  1 , Bettia Celestin  2 , Felipe Kazmirczak  1 , Shadi P Bagherzadeh  2 , Kurt W Prins  1 , Sasha Z Prisco  1 , E Kenneth Weir  1 , Roham Zamanian  3 , Francois Haddad  4 , Thenappan Thenappan  5
Affiliations
Comparative Study

Comparison of the prognostic value of right atrial echocardiographic parameters in pulmonary arterial hypertension

Danny Mohama et al. J Heart Lung Transplant. 2025 Aug.

Abstract

Pulmonary arterial hypertension (PAH) guidelines advocate measures of area for right atrial (RA) dimensions, while echocardiographic guidelines recommend RA volume. We compared the prognostic value of RA echocardiographic parameters to predict transplant-free survival in 332 adult patients with PAH. RA area correlated strongly with volume (r = 0.96). After adjusting for age and sex, for every 1-standardized unit increase in RA area index, volume index, and major axis dimension, there were 21%, 18%, and 18% higher hazards of mortality or transplant, respectively. However, no RA parameter was independently associated with transplant-free survival when adjusted for Registry to Evaluate Early and Long-Term PAH Disease Management lite score. RA area index had the highest area under the curve for predicting transplant-free survival.

Keywords: area; pulmonary hypertension; right ventricle; survival; volume.

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Conflict of interest statement

Disclosure statement Kurt W. Prins: grant funding from Bayer. Sasha Prisco: Speakers bureau for Merck. Francois Haddad: received research funding for investigator-initiated study by Janssen on computational approaches to surrogate end-point research in pulmonary hypertension. Thenappan Thenappan: served as consultant to United Therapeutics, J&J, Merck, Aria CV, Gossiermer Bio, and Altvant Science. Danny Mohama, Pitchaya Worapongsatitaya, Bettia Celestin, Felipe Kazmirczak, Shadi P. Bagherzadeh, E Kenneth Weir, Roham Zamanian: None. This study was supported by Vikkie Auzzene Philanthropic funds.

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