{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:37:56Z","timestamp":1793813876055,"version":"4.6.1"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left atrial analysis is employed in diastolic assessment with left atrial volume index (LAVI) incorporated in the 2016 ASE\/EACVI diastology guideline algorithm. LAVI has sub\u2010optimal correlation with invasive left ventricular filling pressure (LVFP) and incorporation of left atrial reservoir strain (LASr) may improve diastolic assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional prospective study of 139 patients was undertaken with all patients undergoing transthoracic echocardiography immediately prior to cardiac catheterization with invasive evaluation of LVFP. LASr by speckle tracking echocardiography and conventional echocardiographic parameters were assessed in relation to invasive LVFP. Modification of the 2016 guideline algorithm was performed with incorporation of LASr in place of LAVI (LASr \u226423% indicating elevated LVFP). Accuracy of the modified and conventional algorithm were assessed for predicting invasive LVFP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 63\u00b112 years with 27% female. LASr demonstrated superior correlation and receiver operator characteristic for predicting LVFP than LAVI (LASr: r \u2010.46 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), AUC: .82\u00a0vs LAVI: r .19 (<jats:italic>p<\/jats:italic> 0.02), AUC: .66). LASr of \u226423% was the optimal cut\u2010off for discriminating elevated LVFP (sensitivity 80%, specificity 77%). Modification of the 2016 algorithm with incorporation of LASr in place of LAVI reclassified 12% of the patient cohort and improved concordance of echocardiographic and invasive LVFP assessment (modified algorithm <jats:italic>\u03ba<\/jats:italic> .47\u00a0vs 2016 algorithm <jats:italic>\u03ba<\/jats:italic>: .33). No patients were incorrectly reclassified by modified algorithm assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LASr better predicts invasive LVFP than LAVI. Modification of the 2016 guideline algorithm with incorporation of LASr in place of LAVI improves accuracy of echocardiographic assessment of LVFP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15157","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T11:54:50Z","timestamp":1628250890000},"page":"1503-1513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Left atrial reservoir strain provides incremental value to left atrial volume index for evaluation of left ventricular filling pressure"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-6010","authenticated-orcid":false,"given":"Stephen","family":"Tomlinson","sequence":"first","affiliation":[{"name":"Department of Cardiology The Prince Charles Hospital  Brisbane Australia"},{"name":"School of Medicine and Menzies Health Institute Queensland Griffith University  Gold Coast 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