ArticleRheumatology (Oxford, England)2026
Risk stratifying systemic sclerosis-related pulmonary hypertension by left atrial strain.
Article in Rheumatology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe objective of the study was to explore left atrial (LA) strain, a quantitative index of left ventricular (LV) diastolic function, in risk stratifying patients with SSc-related pulmonary hypertension (SSc-PH).
methodsThis was an exploratory, retrospective single-centre study of 124 patients with SSc-PH confirmed on right heart catheterization. We quantified and clustered the three components of LA global longitudinal strain (GLS): (i) reservoir (systole); (ii) conduit (early diastole); and (iii) contractile (late diastole), using echocardiograms closest to timing of right heart catheterization. We applied both the Kaplan-Meier method and a Cox proportional hazards model to determine associations with our primary outcome of all-cause mortality.
resultsUsing k-means clustering, we divided our cohort into three clusters: Cluster 1 (N = 40), Cluster 2 (N = 34) and Cluster 3 (N = 50). Compared with Cluster 1, Cluster 2 had the lowest median LA conduit strain, and Cluster 3 exhibited the lowest median LA contractile strain. There was a statistically significant difference in survival between clusters (log-rank P = 0.005). Median survival was 122.4 months, 67.9 months and 48.4 months for Cluster 1, Cluster 2 and Cluster 3, respectively. Compared with those in Cluster 1, patients in Cluster 2 and Cluster 3 had adjusted hazard ratios of 1.46 (95% CI: 0.71, 2.97) and 2.57 (95% CI: 1.32, 5.02) for all-cause mortality, respectively.
conclusionOf the three LA GLS clusters, Cluster 3 had the shortest median survival. LA GLS may provide further risk stratification of patients with SSc-PH.
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