{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:10:37Z","timestamp":1788487837028,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,1,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Left atrial (LA) function plays a pivotal role in modulating left ventricular performance. The aim of our study was to evaluate the relationship between resting LA function by strain analysis and exercise capacity in patients with chronic kidney disease (CKD) and evaluate its utility compared with exercise E\/e'.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Consecutive patients with stage 3 and 4 CKD without prior cardiac history were prospectively recruited from outpatient nephrology clinics and underwent clinical evaluation and resting and exercise stress echocardiography. Resting echocardiographic parameters including E\/e' and phasic LA strain (LA reservoir [LASr], conduit, and contractile strain) were measured and compared with exercise E\/e'. A total of 218 (63.9\u00b111.7\u00a0years, 64% men) patients with CKD were recruited. Independent clinical parameters associated with exercise capacity were age, estimated glomerular filtration rate, body mass index, and sex (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 for all), while independent resting echocardiographic parameters included E\/e', LASr, and LA contractile strain (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 for all). Among resting echocardiographic parameters, LASr demonstrated the strongest positive correlation to metabolic equivalents achieved (r=0.70;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). Receiver operating characteristic curves demonstrated that LASr (area under the curve, 0.83) had similar diagnostic performance as exercise E\/e' (area under the curve, 0.79;\n              <jats:italic>P<\/jats:italic>\n              =0.20 on DeLong test). A model combining LASr and clinical metrics showed robust association with metabolic equivalents achieved in patients with CKD.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LASr, a marker of decreased LA compliance is an independent correlate of exercise capacity in patients with stage 3 and 4 CKD, with similar diagnostic value to exercise E\/e'. Thus, LASr may serve as a resting biomarker of functional capacity in this population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017840","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T12:44:40Z","timestamp":1609245880000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Left Atrial Reservoir Strain by Speckle Tracking Echocardiography: Association With Exercise Capacity in Chronic Kidney Disease"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6430-2743","authenticated-orcid":false,"given":"Gary C.H.","family":"Gan","sequence":"first","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"},{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"},{"name":"University of New South Wales Sydney NSW Australia"},{"name":"Western Sydney University Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6357-4808","authenticated-orcid":false,"given":"Aditya","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"},{"name":"University of New South Wales Sydney NSW Australia"},{"name":"Western Sydney University Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-5118","authenticated-orcid":false,"given":"Henry H.L.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennith H.","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"},{"name":"Western Sydney University Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6619-6275","authenticated-orcid":false,"given":"Krishna K.","family":"Kadappu","sequence":"additional","affiliation":[{"name":"University of New South Wales Sydney NSW Australia"},{"name":"Western Sydney University Sydney NSW Australia"},{"name":"Department of Cardiology Liverpool Hospital Sydney NSW Australia"},{"name":"Department of Cardiology Campbelltown Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1253-6393","authenticated-orcid":false,"given":"Karen","family":"Byth","sequence":"additional","affiliation":[{"name":"Research and Education Network Western Sydney Local Health District Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Eshoo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Blacktown Hospital Sydney NSW Australia"},{"name":"Western Sydney University Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6045-7780","authenticated-orcid":false,"given":"Liza","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westmead Hospital Sydney NSW Australia"},{"name":"University of New South Wales Sydney NSW Australia"},{"name":"University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011858"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.681"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01501005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000355568"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000486938"},{"key":"e_1_3_2_7_2","first-page":"30631","article-title":"Exercise e\/e' is a determinant of exercise capacity and adverse cardiovascular outcomes in chronic kidney disease","volume":"1936","author":"Gan GCH","year":"2020","unstructured":"Gan GCH, Kadappu KK, Bhat A, Fernandez F, Eshoo S, Thomas L. 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