Diagnostic Value of strain parameters in the evaluation of
probability of PH
Finally, we evaluate the ability of strain parameters to predict the
presence of PH and to categorize severity in patients with probability
of PH. Compared with other echocardiographic parameters (RVFAC, TAPSE,
TEI), both RV-FWS and RA-GS showed an adequate AUC to identify the
presence of pulmonary hypertension and their respective severity
categories. RA-GS outperformed other echocardiographic parameters to
detect those patients with any degree of pulmonary hypertension (AUC:
0.691, 95% CI: 0.621-0.762), while RV-FWS outperformed in those with
high probability of pulmonary hypertension (AUC: 0.886, 95% CI
0.832-0.940) (Figure 6 ). RV-FWS of -27.30%, -22.60%, and
-22.10% had an optimal AUC and predictive test performance to predict
presence of pulmonary hypertension, and to predict intermediate-to-high
probability of pulmonary hypertension, and high pulmonary hypertension,
respectively. Furthermore, our identified cut-off values for RA-GS were
26.30%, 34.36%, and 37.20% to detect the previously mentioned
categories (Table 2 ). Using the previously identified cut-off
values in our multivariate logistic regression models, we found a
significantly increased likelihood for pulmonary hypertension
categories, which were maintained after adjustment for covariates
(Table 3 ).