Continuous variables were expressed as the mean ± standard deviation or median (interquartile range), and categorical variables were expressed as the number with proportions. The comparisons of continuous variables were assessed using the paired t-test or nonparametric test between two groups, and one-way ANOVA with a post hoc test or Kruskal-Wallis test between more than two groups. The comparisons of categorical variables were assessed using chi-square test or Fisher’s exact test. Subjects were graded according to tertiles of RA SD-TPS (%) and interatrial dyssynchrony at high altitude, respectively (grade 1: <33rd, grade 2: 33rd-66th, grade 3: ≥66th). Linear trend in continuous variables according to RA SD-TPS (%) grade was tested by the liner regression analysis in Table 2. Univariable linear regression analysis was performed to assess the related variables for RA dyssynchrony, and variables with p<0.1 were entered to the stepwise multivariable linear regression. Statistical analysis was performed using SPSS 22.0 (IBM Corp., Armonk, NY, USA) and Graphpad Prism 7.0 (Inc., La Jolla, USA).

Data are expressed as mean ± standard deviation or median (25th to 75th quartile). Bold values indicate statistically significant. *p for trend <0.05. RA, right atrium; BMI, body mass index; HR, heart rate; SpO2, arterial pulse oxygen saturation; SBP, systolic blood pressure; DBP, diastolic blood pressure; LVEF, left ventricle ejection fraction; E/A, ratio of peak early to late diastolic annular inflow velocity; RV, right ventricle; FAC, fractional area change; TAM, tricuspid annular motion; GLS, global longitudinal strain; PAAT, pulmonary artery systolic wave acceleration time; mPAP, mean pulmonary arterial pressure; TRV, tricuspid regurgitation velocity; sPAP, systolic pulmonary arterial pressure; Vmax, maximal volume index; Vpre-A, pre-systolic volume index; Vmin, minimal volume index; EFtot, total emptying fraction; EFpass, passive emptying fraction; EFact, active emptying fraction; RAS, right atrial strain during the reservoir phase.

Intra- and inter-observer variabilities for RA function and dyssynchrony were assessed in 10 randomly selected subjects at sea level and high altitude by the same observer and by two independent observers, respectively, using the intra-class correlation coefficient by Cronbach’s α. The value below 0.05 was defined significant for all hypothesis tests.

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