AUTHOR=Jurica Jakub , Péč Martin Jozef , Cingel Marek , Bolek Tomáš , Focko Boris , Barbierik Vachalcová Marianna , Mokáň Marián , Samoš Matej TITLE=Right atrial and right ventricular strain in patients with acute decompensated heart failure: a pilot study JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1621473 DOI=10.3389/fcvm.2025.1621473 ISSN=2297-055X ABSTRACT=AimsThe aim of this study was to compare the right atrial (RAS: reservoir-R, conduit-CD, contraction-CT) and right ventricular strain (global longitudinal-RV-GS, free wall strain-RV-FWS) between patients with acute decompensation of chronic heart failure (ADHF) and a control group.MethodsThis study enrolled eighteen patients admitted to our ward for ADHF. Transthoracic echocardiography (TTE) with two-dimensional speckle tracking analysis (2D ST) was performed in each patient. The cut-off value of ≤40% was used to distinguish HF with reduced (HFrEF) from HF with preserved ejection fraction (HFpEF). The control group consisted of eighteen healthy individuals with no known history of cardiovascular disease. HF patients were followed for 6-months for HF-related adverse events (cardiovascular death or HF-related hospitalisation).ResultsWe found that RV-GS and RV-FWS were significantly lower in ADHF in comparison with the control group (RV-GS: −15.7 ± 3.32% vs. −22.6 ± 2.26%, p < 0.001; RV-FWS: −19.2 ± 4.7% vs. −25.9 ± 2.54%, p < 0.001). There was no significant difference in RV-GS and RV-FWS between the HFrEF and HFpEF subgroups. Additionally, R-RAS, CD-RAS and CT-RAS were significantly changed in HF patients compared to controls (R-RAS: 10.1 ± 5.5% vs. 42.5 ± 11.8%, p < 0.001; CD-RAS −8.1 ± 4.5% vs. −27.5 ± 9.3%, p < 0.001; CT-RAS: −2.1 ± 1.0% vs. −14.3 ± 6.1%, p < 0.001), and predicted major cardiovascular event in a 6-month follow-up period.ConclusionOur study demonstrated a significant difference in RAS, RV-GS and RV-FWS in patients with acute decompensation of HF in comparison with the control group, with no significant difference between the HFrEF and HFpEF subgroups. RAS predicted adverse events in a 6-month follow-up period.