{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:01:57Z","timestamp":1781730117309,"version":"3.54.5"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Transition from an asymptomatic to symptomatic state in severe aortic stenosis is often difficult to assess. Identification of a morphological sign of increased hemodynamic load may be important in asymptomatic aortic stenosis to identify patients at risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Thirty-nine patients with asymptomatic severe aortic stenosis (aortic valve area &lt;1 cm\n              <jats:sup>2<\/jats:sup>\n              , peak jet velocity &gt;3.5 m\/s) underwent exercise testing with simultaneous invasive hemodynamic monitoring and Doppler echocardiography. Cardiac index, pulmonary artery pressure, and pulmonary capillary wedge pressure (PCWP) were recorded. Patients were followed up for the composite end point of death, unplanned hospitalization, or aortic valve replacement. Patients were stratified into 2 groups according to left atrial (LA) volume index \u226535 mL\/m\n              <jats:sup>2<\/jats:sup>\n              . In 25 patients (64%) LA volume index was \u226535 mL\/m\n              <jats:sup>2<\/jats:sup>\n              . Aortic valve area was similar between groups (0.81\u00b10.15 versus 0.84\u00b10.18 cm\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.58). PCWP was higher at rest and during exercise in patients with LA volume index \u226535 mL\/m\n              <jats:sup>2<\/jats:sup>\n              (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), despite similar cardiac index. At rest, PCWP was &lt;12 mm\u2009Hg in 11 patients (44%) with LA dilatation, whereas PCWP was &lt;25 mm\u2009Hg in 1 patient (4%) with exercise. LA volume index and E\/e\u2032 predicted exercise PCWP&gt;30 mm\u2009Hg with areas under the receiver operating curve of 0.75 and 0.84, respectively. During follow-up, 14 cardiac events were recorded. LA volume was associated with a hazard ratio of 1.90 (95% confidence interval, 0.92\u20134.15).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>LA size reflects hemodynamic burden in patients with asymptomatic severe aortic stenosis. Quantitative measurements of LA and diastolic function are associated with left ventricular filling pressures with exercise and could be used to identify asymptomatic patients with increased hemodynamic burden.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02395107.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.116.005156","type":"journal-article","created":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T17:30:14Z","timestamp":1476207014000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Association Between Left Atrial Dilatation and Invasive Hemodynamics at Rest and During Exercise in Asymptomatic Aortic Stenosis"],"prefix":"10.1161","volume":"9","author":[{"given":"Nicolaj Lyhne","family":"Christensen","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi Sanchez","family":"Dahl","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"Carter-Storch","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rine","family":"Bakkestr\u00f8m","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Jensen","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flemming Hald","family":"Steffensen","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Vad","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Videb\u00e6k","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob Eifer","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Odense University Hospital, Denmark (N.L.C., J.S.D., R.C.-S., R.B., E.V.S., L.V., J.E.M.); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense (K.J.), and Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.5.1105"},{"key":"e_1_3_3_4_2","first-page":"IV73","article-title":"Diastolic dysfunction in aortic stenosis.","volume":"87","author":"Hess OM","year":"1993","unstructured":"Hess OM, Villari B, Krayenbuehl HP. 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