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

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.