Pulmonary vascular disease & thromboembolism
Abnormal Left Atrial Strain by CMR Is Associated With Left Heart Disease in Patients With Pulmonary Hypertension
Authors' conclusion
LA functional impairment is a sign of left heart involvement in patients with PH. Left atrial reservoir function emerged superior for the identification of left heart disease unmasked during exercise stress compared with left ventricular global longitudinal strain.
Study context
- Population
- Patients referred to both right heart catheterization and CMR, classified by right heart catheterization126 with exercise stress catheterization
- Participants
- 209 patients
- Exposure
- Left atrial (LA) strain across pulmonary hypertension (PH) haemodynamic subtypes; LA reservoir function vs LV global longitudinal strain for detecting left heart disease
- Normaln = 55reference
- Precapillaryn = 72
- CpcPHn = 27
- Isolated postcapillary pulmonary hypertension (IpcPH)n = 15
- Exercise PHn = 34
- Unclassified PHn = 6
- Outcome
- LA reservoir function
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
IpcPH vs Normal: P < 0.001 · IpcPH vs Precapillary: P < 0.001 · IpcPH vs Exercise PH: P = 0.039 · CpcPH vs Exercise PH: P = 0.048
Observational data: associations, not effects.
Further findings
| Outcome | LA reservoir function | LV global longitudinal strain | P value |
|---|---|---|---|
| Diagnostic performance for PCWP ≥15 mm Hg at rest: LA reservoir function vs LV global longitudinal strain | P = 0.20 | ||
| AUC | 0.81 | 0.77 | |
| Diagnostic performance for exercise-induced PCWP ≥25 mm Hg: LA reservoir function vs LV global longitudinal strain | P = 0.039 | ||
| AUC | 0.79 | 0.70 |
Original publication
Abnormal Left Atrial Strain by CMR Is Associated With Left Heart Disease in Patients With Pulmonary Hypertension. Circ Heart Fail. Published 31 August 2025. doi:10.
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