Right ventricular and right atrial dilatation phenotypes in pulmonary arterial hypertension

Extract Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular resistance and afterload on the right heart. The degree of right ventricular (RV) adaptation determines exercise capacity and prognosis[1]. RV dilatation and RV-pulmonary artery coupling parameters show prognostic value in addition to current risk stratification tools[2]. Right atrial function also contributes to PAH risk assessment since RA pressure and volume are associated with mortality[3, 4]. Previously, we have shown that the right atrium is more severely dilated than the ventricle in patients with severe RV diastolic stiffness[5, 6]. However, the RV end-diastolic volume (EDV) was not different in patients with or without severe RV diastolic stiffness. Therefore, the aim of this study was to gain a deeper understanding of the clinical and prognostic significance of RV and RA dilatation phenotypes in PAH.