AIM To investigate the correlation between right atrial pressure (RAP) and echocardiography (Echo) in patients with pulmonary arterial hypertension (PAH).

METHODS This retrospective analysis included 70 patients with pulmonary arterial hypertension who were hospitalized in our department from May 2021 to October 2023. All patients underwent right heart catheterization and Echo examination and their medical records were collected. The correlation between RAP and right heart function parameters measured by Echo was analyzed by Pearson correlation and meaningful parameters were selected. The independent correlation between RAP and Echo right heart function parameters was assessed by multiple linear regression, and the critical value, sensitivity and specificity of factors affecting RAP > 10 mmHg were analyzed according to the receiver operating characteristic curve (ROC).

RESULTS A total of 70 patients were selected, including idiopathic PAH 61, 5 connective tissue disease related PAH and 4 chronic thromboembolic pulmonary hypertension. RAP and eRAP-IVCd were moderately correlated (correlation coefficient 0.53, P < 0.05), and end-diastolic right ventricular/LV ratio (RV/LV) and inferior vena cava diameter (IVCd) were highly positive correlated to RAP correlation coefficient 0.76 (P < 0.05) and 0.67 (P < 0.05), respectively. Multiple linear regression showed a statistically significant difference in the effect of RV/LV and IVCd on RAP (B=2.36, P < 0.05 and B=0.23, P < 0.05). The ROC curve indicated that IVCd > 17.5mm and RV/LV > 1.24 were the best cut-off values for RAP > 10mmHg, with high sensitivity and specificity.

CONCLUSION RV/LV and IVCd measured by Echo are independently correlated with RAP measured by the right heart catheter, and the former may well predict the latter. RV/LV > 1.24 and IVCd > 17.5mm may indicate RAP > 10mmHg.