{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:46:45Z","timestamp":1792079205102,"version":"4.4.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,8,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Evaluation of whether dyspnea has a cardiac cause is essential. Guidelines from 2016 were reported to result in a high incidence of indeterminate left ventricular (LV) filling pressure. We sought to validate a new algorithm for the estimation of LV filling pressure (LVFP) in a multicenter study, with the objective of decreasing the yield of indeterminate filling pressure and increasing accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In an observational study, echocardiography was performed in 951 patients referred for cardiac catheterization. Echocardiographic measurements included mitral inflow, pulmonary vein and tissue Doppler mitral annulus velocities, tricuspid regurgitation velocity, assessment of mean right atrial pressure, biplane LV and left atrial volumes, and LV and left atrial strain. A stepwise approach was applied in a new algorithm for estimation of LVFP, whereby pressure &gt;15 mm Hg was considered abnormally elevated. The first step included mitral annulus early diastolic velocity (e\u2032), the ratio of mitral early flow velocity to e\u2032, and pulmonary artery systolic pressure. With concordant findings in all 3 variables, conclusions about LVFP could be reached. In case of discordant or incomplete variables, left atrial reservoir strain, left atrial maximum volume index, isovolumic relaxation time, and pulmonary vein flow were analyzed in a second step. In the presence of \u22651 abnormal measurement in the second step, the conclusion of elevated LVFP could be reached.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Only 2 patients had indeterminate LVFP as per the new algorithm versus 38 applying 2016 guidelines (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001). In 949 patients, sensitivity was 86% and specificity was 86%, with accuracy of 86%. Accuracy was higher than the 2016 algorithm in all patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001), and in patients with ejection fraction \u226550% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001), whereas accuracy was similar in patients with ejection fraction &lt;50%. In 663 patients with natriuretic peptides data, net reclassification improvement for echocardiography over natriuretic peptides was 1.1 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001), and integrated discrimination improvement was 0.3 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The new algorithm increases the feasibility of estimating LVFP and has good accuracy with incremental value when natriuretic peptides are considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.074974","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T12:29:37Z","timestamp":1751027377000},"page":"424-435","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":51,"title":["New Algorithm for Estimating Left Ventricular Filling Pressure by Echocardiography"],"prefix":"10.1161","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7648-3229","authenticated-orcid":true,"given":"Hossam","family":"Lababidi","sequence":"first","affiliation":[{"name":"Methodist DeBakey Heart and Vascular Center, Houston, TX (H.L., W.R., S.F.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wissam","family":"Rahi","sequence":"additional","affiliation":[{"name":"Methodist DeBakey Heart and Vascular Center, Houston, TX (H.L., W.R., S.F.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3005-9954","authenticated-orcid":true,"given":"Otto A.","family":"Smiseth","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Rikshospitalet and University of Oslo, Norway (O.A.S., F.H.K., \u00d8.S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1061-1639","authenticated-orcid":true,"given":"Kristen","family":"Billick","sequence":"additional","affiliation":[{"name":"Scripps Clinic and La Jolla Hospital in La Jolla, CA (K.B., R.C.M., J.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7922-0521","authenticated-orcid":true,"given":"Katsuji","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pulmonology, Hypertension &amp; Nephrology, Ehime University Graduate School of Medicine, Toon, Japan (K.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faraz H.","family":"Khan","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Rikshospitalet and University of Oslo, Norway (O.A.S., F.H.K., \u00d8.S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind S.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Rikshospitalet and University of Oslo, Norway (O.A.S., F.H.K., \u00d8.S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eusebio","family":"Garc\u00eda-Izquierdo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain (E.G.-I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-2958","authenticated-orcid":true,"given":"Jong-Won","family":"Ha","sequence":"additional","affiliation":[{"name":"Cardiology Division, Yonsei University College of Medicine, Seoul, Korea (J.-W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Ohte","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Japan (N.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einar","family":"Gude","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Rikshospitalet, Norway (E.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-9017","authenticated-orcid":true,"given":"Rajeev C.","family":"Mohan","sequence":"additional","affiliation":[{"name":"Scripps Clinic and La Jolla Hospital in La Jolla, CA (K.B., R.C.M., J.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Thomas","family":"Heywood","sequence":"additional","affiliation":[{"name":"Scripps Clinic and La Jolla Hospital in La Jolla, CA (K.B., R.C.M., J.T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9240-8369","authenticated-orcid":true,"given":"Allan","family":"Klein","sequence":"additional","affiliation":[{"name":"Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (A.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4911-8056","authenticated-orcid":true,"given":"Sherif F.","family":"Nagueh","sequence":"additional","affiliation":[{"name":"Methodist DeBakey Heart and Vascular Center, Houston, TX (H.L., W.R., S.F.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex252"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa415"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.058"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey042"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz641"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.10.017"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2023.12.004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.01.025"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.963496"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeab154"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.10.038"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2022.10.011"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.08.112"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.125.074974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T20:36:07Z","timestamp":1774902967000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.125.074974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,8,19]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.125.074974"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.125.074974","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]},"assertion":[{"value":"2025-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}