Background: While right atrial (RA) enlargement is an established marker for adverse outcomes, the prognostic importance of RA dysfunction independent of RA size in pulmonary arterial hypertension (PAH) is not known. Methods and Results: Study subjects with PAH were prospectively enrolled from 2010 to 2014. RA function was measured using RA speckle-tracking longitudinal strain (LS) and strain rate (SR) during each phase of the cardiac cycle: (I) RA reservoir (peak longitudinal strain [PLS], peak systolic SR [PSSR]), (II) RA conduit (peak early diastolic SR [PEDSR]), and (III) RA active contraction (peak active contraction strain [PACS], peak contraction SR [PCSR]). The primary outcome was a composite of time to hospitalization or death assessed on follow up. A total of 63 subjects had complete echocardiographic data. Of these, 91% were females and the mean age was 58 ± 12 years. During the follow-up period (range:1–58 months), 39 were hospitalized or had died. After multivariable adjustment for age, gender and LA size, PLS, PACS, and PEDSR were significantly associated with increased risk of the composite outcome (p=0.0005, p=0.0167 and p=0.0054 respectively). Conclusion: Right atrial dysfunction independently predicts mortality and hospitalizations in patients with pulmonary arterial hypertension.

The Project Baseline Health Study (PBHS) was launched to map human health through a comprehensive understanding of both the health of an individual and how it relates to the broader population. The study will contribute to the creation of a biomedical information system that accounts for the highly complex interplay of biological, behavioral, environmental, and social systems. The PBHS is a prospective, multicenter, longitudinal cohort study that aims to enroll thousands of participants with diverse backgrounds who are representative of the entire health spectrum. Enrolled participants will be evaluated serially using clinical, molecular, imaging, sensor, self-reported, behavioral, psychological, environmental, and other health-related measurements. An initial deeply phenotyped cohort will inform the development of a large, expanded virtual cohort. The PBHS will contribute to precision health and medicine by integrating state of the art testing, longitudinal monitoring and participant engagement, and by contributing to the development of an improved platform for data sharing and analysis.

Global RVLS values between VSS systems are not significantly different but may differ slightly from VIS. When comparing regional strain between VSS and VIS analyses, there is widespread variability without clear systematic differences.

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