{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:37:11Z","timestamp":1789832231369,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Advanced heart failure (AdHF) is characterized by variable degrees of left ventricular (LV) dysfunction, myocardial fibrosis, and raised filling pressures which lead to left atrial (LA) dilatation and cavity dysfunction. This study investigated the relationship between LA peak atrial longitudinal strain (PALS), assessed by speckle-tracking echocardiography (STE), and invasive measures of LV filling pressures and fibrosis in a group of AdHF patients undergoing heart transplantation (HTX).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We consecutively enrolled patients with AdHF who underwent HTX at our Department. Demographic and basic echocardiographic data were registered, then invasive intracardiac pressures were obtained from right heart catheterization, and STE was also performed. After HTX, biopsy specimens from explanted hearts were collected to quantify the degree of LV myocardial fibrosis. Sixty-four patients were included in the study (mean age 62.5 \u00b1 11 years, 42% female). The mean LV ejection fraction (LVEF) was 26.7 \u00b1 6.1%, global PALS was 9.65 \u00b1 4.5%, and mean pulmonary capillary wedge pressure (PCWP) was 18.8 \u00b1 4.8\u2005mmHg. Seventy-three % of patients proved to have severe LV fibrosis. Global PALS was inversely correlated with PCWP (R = \u22120.83; P &amp;lt; 0.0001) and with LV fibrosis severity (R = \u22120.78; P &amp;lt; 0.0001) but did not correlate with LVEF (R = 0.15; P = 0.2). Among echocardiographic indices of LV filling pressures, global PALS proved the strongest [area under the curve 0.955 (95% confidence interval 0.87\u20130.99)] predictor of raised (&amp;gt;18\u2005mmHg) PCWP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with AdHF, reduced global PALS strongly correlated with the invasively assessed LV filling pressure and degree of LV fibrosis. Such relationship could be used as non-invasive indicator for optimum patient stratification for therapeutic strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead340","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T23:03:40Z","timestamp":1702681420000},"page":"446-453","source":"Crossref","is-referenced-by-count":20,"title":["Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-3006","authenticated-orcid":false,"given":"Giulia Elena","family":"Mandoli","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7223-141X","authenticated-orcid":false,"given":"Maria Concetta","family":"Pastore","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinando","family":"Loiacono","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Maria","family":"Righini","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"D\u2019Ascenzi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Focardi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Cavigli","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Lisi","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"},{"name":"Division of Cardiology, Department of Cardiovascular Diseases\u2014AUSL Romagna, \u2018Santa Maria delle Croci\u2019 Hospital , Ravenna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Bisleri","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, St. Michael Hospital , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Dokollari","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, St. Michael Hospital , Toronto, ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bernazzali","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese , Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Maccherini","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese , Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serafina","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , Viale Mario Bracci, 1, 53100 Siena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y","family":"Henein","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Medicine, Umea University , Umea , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,18]]},"reference":[{"key":"2024032707104723600_jead340-B1","first-page":"331","article-title":"Pulmonary vascular resistance and the risk of heart transplantation","volume":"7","author":"Kirklin","year":"1988","journal-title":"J Heart Transplant"},{"key":"2024032707104723600_jead340-B2","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1161\/CIRCHEARTFAILURE.112.000204","article-title":"Relationship of right- to left-sided ventricular filling pressures in advanced heart failure: insights from the ESCAPE trial","volume":"6","author":"Drazner","year":"2013","journal-title":"Circ Heart Fail"},{"key":"2024032707104723600_jead340-B3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.healun.2011.09.003","article-title":"Relationship of right- and left-sided filling pressures in patients with advanced heart failure: a 14-year multi-institutional analysis","volume":"31","author":"Drazner","year":"2012","journal-title":"J Heart Lung Transplant"},{"key":"2024032707104723600_jead340-B4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.healun.2004.01.010","article-title":"The prognostic use of right heart catheterization data in patients with advanced heart failure: how relevant are invasive procedures in the risk stratification of advanced heart failure in the era of neurohormones?","volume":"24","author":"Gardner","year":"2005","journal-title":"J Heart Lung Transplant"},{"key":"2024032707104723600_jead340-B5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1053\/euhj.1998.1155","article-title":"High and low pulmonary vascular resistance in heart transplant candidates. A 5-year follow-up after heart transplantation shows continuous reduction in resistance and no difference in complication rate","volume":"20","author":"Lindel\u00f6w","year":"1999","journal-title":"Eur Heart J"},{"key":"2024032707104723600_jead340-B6","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s10741-019-09889-9","article-title":"Left atrial strain in left ventricular diastolic dysfunction: have we finally found the missing piece of the puzzle?","volume":"25","author":"Mandoli","year":"2020","journal-title":"Heart Fail Rev"},{"key":"2024032707104723600_jead340-B7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0002-9149(77)80182-3","article-title":"Correlative classification of clinical and hemodynamic function after acute myocardial infarction","volume":"39","author":"Forrester","year":"1977","journal-title":"Am J Cardiol"},{"key":"2024032707104723600_jead340-B8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B9","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ehjci\/jew082","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B10","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1111\/echo.14339","article-title":"More than 10 years of speckle tracking echocardiography: still a novel technique or a definite tool for clinical practice?","volume":"36","author":"Cameli","year":"2019","journal-title":"Echocardiography"},{"key":"2024032707104723600_jead340-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjci\/jeu184","article-title":"Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"16","author":"Voigt","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B12","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/ehjci\/jey042","article-title":"Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"19","author":"Badano","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B13","doi-asserted-by":"crossref","first-page":"946","DOI":"10.3390\/diagnostics10110946","article-title":"Multicentric Atrial Strain COmparison between Two different modalities: MASCOT HIT study","volume":"10","author":"Cameli","year":"2020","journal-title":"Diagnostics (Basel)"},{"key":"2024032707104723600_jead340-B14","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.carpath.2010.01.011","article-title":"Histopathologic correlates of myocardial improvement in patients supported by a left ventricular assist device","volume":"20","author":"Segura","year":"2011","journal-title":"Cardiovasc Pathol"},{"key":"2024032707104723600_jead340-B15","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/echo.13094","article-title":"Correlation of left atrial strain and Doppler measurements with invasive measurement of left ventricular end-diastolic pressure in patients stratified for different values of ejection fraction","volume":"33","author":"Cameli","year":"2016","journal-title":"Echocardiography"},{"key":"2024032707104723600_jead340-B16","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1093\/ehjci\/jeab194","article-title":"Corrigendum to: Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure","volume":"23","author":"Inoue","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1161\/01.CIR.100.4.427","article-title":"Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function","volume":"100","author":"Barbier","year":"1999","journal-title":"Circulation"},{"key":"2024032707104723600_jead340-B18","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1007\/s10554-015-0718-7","article-title":"Comparison of the reliability of E\/E\u2032 to estimate pulmonary capillary wedge pressure in heart failure patients with preserved ejection fraction versus those with reduced ejection fraction","volume":"31","author":"Matsushita","year":"2015","journal-title":"Int J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B19","doi-asserted-by":"crossref","first-page":"e007696","DOI":"10.1161\/CIRCIMAGING.118.007696","article-title":"Left atrial reservoir function and outcome in heart failure with reduced ejection fraction","volume":"11","author":"Carluccio","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B20","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.echo.2016.07.012","article-title":"Prognostic value of left atrial strain in outpatients with de novo heart failure","volume":"29","author":"Sanchis","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"2024032707104723600_jead340-B21","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1002\/ejhf.147","article-title":"Impaired left atrial function in heart failure with preserved ejection fraction","volume":"16","author":"Santos","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2024032707104723600_jead340-B22","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.amjcard.2019.03.041","article-title":"Prognosis and risk stratification of patients with advanced heart failure (from PROBE)","volume":"124","author":"Cameli","year":"2019","journal-title":"Am J Cardiol"},{"key":"2024032707104723600_jead340-B23","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s10741-019-09865-3","article-title":"Basic and advanced echocardiography in advanced heart failure: an overview","volume":"25","author":"Pastore","year":"2020","journal-title":"Heart Fail Rev"},{"key":"2024032707104723600_jead340-B24","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1093\/ehjci\/jeab154","article-title":"Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging","volume":"23","author":"Smiseth","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B25","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1002\/ehf2.13722","article-title":"New echocardiographic indices of shift to biventricular failure to optimize risk stratification of chronic heart failure","volume":"9","author":"Mandoli","year":"2022","journal-title":"ESC Heart Fail"},{"key":"2024032707104723600_jead340-B26","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1093\/ehjci\/jeab106","article-title":"Left atrial strain by speckle tracking predicts atrial fibrosis in patients undergoing heart transplantation","volume":"23","author":"Lisi","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2024032707104723600_jead340-B27","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.hrthm.2014.09.044","article-title":"Associations of electrocardiographic P-wave characteristics with left atrial function, and diffuse left ventricular fibrosis defined by cardiac magnetic resonance: the PRIMERI study","volume":"12","author":"Tiffany Win","year":"2015","journal-title":"Heart Rhythm"},{"key":"2024032707104723600_jead340-B28","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijcard.2019.03.063","article-title":"The analysis of left atrial function predicts the severity of functional impairment in chronic heart failure: the FLASH multicenter study","volume":"286","author":"Cameli","year":"2019","journal-title":"Int J Cardiol"},{"key":"2024032707104723600_jead340-B29","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.amjcard.2012.10.049","article-title":"Usefulness of atrial deformation analysis to predict left atrial fibrosis and endocardial thickness in patients undergoing mitral valve operations for severe mitral regurgitation secondary to mitral valve prolapse","volume":"111","author":"Cameli","year":"2013","journal-title":"Am J Cardiol"},{"key":"2024032707104723600_jead340-B30","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.ijcard.2020.09.009","article-title":"Left atrial strain as a pre-operative prognostic marker for patients with severe mitral regurgitation","volume":"324","author":"Mandoli","year":"2021","journal-title":"Int J Cardiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/advance-article-pdf\/doi\/10.1093\/ehjci\/jead340\/54932389\/jead340.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/25\/4\/446\/57097181\/jead340.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/25\/4\/446\/57097181\/jead340.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T08:09:29Z","timestamp":1711526969000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/25\/4\/446\/7477291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,18]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,12,18]]},"published-print":{"date-parts":[[2024,3,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jead340","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4]]},"published":{"date-parts":[[2023,12,18]]}}}