Diagnostic performance of right heart chambers strain parameters
We sought to evaluate the diagnosis performance of RV-FWS and RA-GS to
predict categories of pulmonary hypertension severity. Receiver
operating characteristic curve (ROC) analysis curves were generated and
area under the curve (AUC) derived for RV and RA strain and compared
with the Fraction of Shortening, TAPSE, TEI, which are commonly used
echocardiographic parameters to evaluate right heart ventricle
functionality. Furthermore, we sought to identify the optimal cut-off
value of the strain parameters using the ”Youden method” from the R
package ”Optimal cut points ” and evaluate the diagnostic test
capacity, AUC, sensitivity, specificity, positive and negative
predictive values (VPP, VPN, respectively) to predict pulmonary
hypertension categories (14). Finally, we performed logistic regression
models to assess the likelihood to have each pulmonary hypertension
categories with their respective identified cut-off value. The goodness
of fit of the logistic regression model was assessed using the Hosmer &
Lemeshow test. All statistical analyses were performed using the R
software (version 3.5.1) (15). A p -value <0.05 was
considered as our statistically significant threshold.