{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:28Z","timestamp":1787017108968,"version":"build-2736575974"},"reference-count":31,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"unspecified","delay-in-days":91,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["1055214"],"award-info":[{"award-number":["1055214"]}]},{"name":"National Health and Medical Research Council of Australia","award":["11358940"],"award-info":[{"award-number":["11358940"]}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["106796"],"award-info":[{"award-number":["106796"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,3,24]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Left ventricular diastolic dysfunction (LVDD) is commonly associated with pulmonary hypertension (PHT); however, the factors associated with the presence and severity of PHT in patients with LVDD have not been well characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed the profiles and echo characteristics of 16\u2009058 adults with LVDD and preserved left ventricular ejection fraction (LVEF, &gt;50%) from the National Echocardiography Database of Australia. Peak tricuspid regurgitation velocity (TRV) was used to determine the presence of PHT. Univariate and multivariate analyses were performed to evaluate the parameters associated with the presence\/increasing severity of PHT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 73\u00b112\u2009years and 9216 (57.4%) were women. 2503 (15.6%) subjects had atrial fibrillation (AF) and 13\u2009555 (84.4%) were in sinus rhythm. Overall, 9976 (62.1%) had PHT (TRV &gt;2.9\u2009m\/s). There was a progressive increase in indexed left atrial volume with rising TRV levels. AF and right ventricular (RV) dilation were strongly associated with the presence of PHT (adjusted OR (aOR) 1.27 (95% CI 1.12 to 1.43) and aOR 4.99 (95% CI 4.44 to 5.62), respectively). Increased age, LVEF and body mass index were also independently associated with PHT (p&lt;0.001). On multivariate analysis, older age, female sex, AF, lower E\/e\u2019 and LVEF were independently associated with the severity of PHT (p&lt;0.001). The presence of AF increased the TRV by an average of 0.32 m\/s, RV dilation by 1.82 m\/s, female sex by 0.32 m\/s and age (per decade) by 0.3 m\/s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large study, PHT was common in LVDD and was strongly associated with the presence of enlarged left atrium, AF and older age, in particular.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12617001387314.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003174","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T19:54:55Z","timestamp":1743623695000},"page":"e003174","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Characteristics of pulmonary hypertension in adults with left ventricular diastolic dysfunction"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4260-2793","authenticated-orcid":false,"given":"Seshika","family":"Ratwatte","sequence":"first","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Stewart","sequence":"additional","affiliation":[{"name":"The University of Notre Dame Australia, Fremantle, Western Australia, Australia"},{"name":"University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Playford","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-7119","authenticated-orcid":false,"given":"Geoff","family":"Strange","sequence":"additional","affiliation":[{"name":"The University of Notre Dame Australia, Fremantle, Western Australia, Australia"},{"name":"Heart Research Institute Ltd, Newtown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"Celermajer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"},{"name":"University of Sydney, Sydney, New South Wales, Australia"},{"name":"Heart Research Institute Ltd, Newtown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"2025081710075292000_12.1.e003174.1","first-page":"2869","article-title":"Pulmonary hypertension in heart failure with preserved ejection fraction: a plea for proper phenotyping and further research","volume":"38","author":"Hoeper","year":"2017","journal-title":"Eur Heart J"},{"key":"2025081710075292000_12.1.e003174.2","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1001\/jamainternmed.2015.0924","article-title":"A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010","volume":"175","author":"Gerber","year":"2015","journal-title":"JAMA Intern 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Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). 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