![]() Importantly, resting LA-GS performed even better in identifying patients with pathological PAWP M either at rest or during stress (AUC: 0.90, p < 0.001), whereas the diagnostic potential of the current algorithm was modest and limited to pEF patients (AUC = 0.72). The diagnostic ability of LA-GS for detecting elevated resting PAWP M (AUC: 0.80, p < 0.001) outperformed that of the recommended algorithm (AUC: 0.69). LA-GS demonstrated a stronger relationship with resting PAWP M ( r = − 0.61, p < 0.001) than any of the indices ( E/ e′, LAVi, TRV max) incorporated in the currently recommended diagnostic algorithm. At rest, 97 patients displayed elevated mean pulmonary arterial wedge pressure (PAWP M) further 32 patients had normal resting, but elevated PAWP M during exercise. 56% had preserved ejection fraction (pEF). Simultaneous echocardiographic and right heart catheterization (RHC) data at rest and during exercise was analyzed in 164 prospectively enrolled patients, referred for RHC due to HF symptoms. Our aim was to investigate whether LA mechanical alterations assessed by LA strain (LA-GS) can contribute to non-invasive LAP diagnostics. ![]() Current recommendations on echocardiographic LAP estimation have limited accuracy. Patients with normal resting left atrial (LA) pressures (LAP), but steep LAP elevation on exertion, pose a particular diagnostic challenge. Left ventricular diastolic pressure estimation is essential for characterization of heart failure (HF).
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