{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:10:43Z","timestamp":1790014243894,"version":"4.0.1"},"reference-count":22,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["NWO-VICI: 918.16.610"],"award-info":[{"award-number":["NWO-VICI: 918.16.610"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["NWO-VIDI: 917.18.338"],"award-info":[{"award-number":["NWO-VIDI: 917.18.338"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2018T059"],"award-info":[{"award-number":["2018T059"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["CVON-2012-08 PHAEDRA"],"award-info":[{"award-number":["CVON-2012-08 PHAEDRA"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["CVON-2017-10 Dolphin-Genesis"],"award-info":[{"award-number":["CVON-2017-10 Dolphin-Genesis"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["CVON-2018-29 PHAEDRA-IMPACT"],"award-info":[{"award-number":["CVON-2018-29 PHAEDRA-IMPACT"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2021,10,24]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary arterial hypertension (PAH) patients have altered right atrial (RA) function and right ventricular (RV) diastolic stiffness. This study assessed the impact of RV diastolic stiffness on RA\u2013RV interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PAH patients with low or high end-diastolic elastance (E\n                      <jats:sub>ed<\/jats:sub>\n                      ) (n=94) were compared with controls (n=31). Treatment response was evaluated in 62 patients. RV and RA longitudinal strain, RA emptying and RV filling were determined and diastole was divided into a passive and active phase. Vena cava backflow was calculated as RA active emptying\u2212RV active filling and RA stroke work as RA active emptying\u00d7RV end-diastolic pressure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With increased E\n                      <jats:sub>ed<\/jats:sub>\n                      , RA and RV passive strain were reduced while active strain was preserved. In comparison to controls, patients had lower RV passive filling but higher RA active emptying and RA stroke work. RV active filling was lower in patients with high E\n                      <jats:sub>ed<\/jats:sub>\n                      , resulting in higher vena cava backflow. Upon treatment, E\n                      <jats:sub>ed<\/jats:sub>\n                      was reduced in ~50% of the patients with high E\n                      <jats:sub>ed<\/jats:sub>\n                      , which coincided with larger reductions in afterload, RV mass and vena cava backflow and greater improvements in RV active filling and stroke volume in comparison with patients in whom E\n                      <jats:sub>ed<\/jats:sub>\n                      remained high.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In PAH, RA function is associated with changes in RV function. Despite increased RA stroke work, severe RV diastolic stiffness is associated with reduced RV active filling and increased vena cava backflow. In 50% of patients with high baseline E\n                      <jats:sub>ed<\/jats:sub>\n                      , diastolic stiffness remained high, despite treatment. A reduction in E\n                      <jats:sub>ed<\/jats:sub>\n                      coincided with a large reduction in afterload, increased RV active filling and decreased vena cava backflow.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.01454-2021","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T12:10:19Z","timestamp":1636632619000},"page":"2101454","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":51,"title":["Right atrial function is associated with right venticular diastolic stiffness: RA\u2013RV interaction in pulmonary arterial hypertension"],"prefix":"10.1183","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2401-7707","authenticated-orcid":false,"given":"Jeroen N.","family":"Wessels","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7804-8352","authenticated-orcid":false,"given":"Sophia A.","family":"Mouratoglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"van Wezenbeek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Louis","family":"Handoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Tim","family":"Marcus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian J.","family":"Meijboom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berend E.","family":"Westerhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harm Jan","family":"Bogaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6700-5058","authenticated-orcid":false,"given":"Gustav J.","family":"Strijkers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-758X","authenticated-orcid":false,"given":"Anton","family":"Vonk Noordegraaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances S.","family":"de Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"2024102102441945000_59.6.2101454.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.027"},{"key":"2024102102441945000_59.6.2101454.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002636"},{"key":"2024102102441945000_59.6.2101454.3","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000716"},{"key":"2024102102441945000_59.6.2101454.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001873"},{"key":"2024102102441945000_59.6.2101454.5","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00156714"},{"key":"2024102102441945000_59.6.2101454.6","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00625-2019"},{"key":"2024102102441945000_59.6.2101454.7","doi-asserted-by":"crossref","first-page":"H156","DOI":"10.1152\/ajpheart.00485.2019","article-title":"Right ventricular function correlates of right atrial strain in pulmonary hypertension: a combined cardiac magnetic resonance and conductance catheter study","volume":"318","author":"Tello","year":"2020","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2024102102441945000_59.6.2101454.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.09.022"},{"key":"2024102102441945000_59.6.2101454.9","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1164\/rccm.201802-0283LE","article-title":"More on single-beat estimation of right ventriculoarterial coupling in pulmonary arterial hypertension","volume":"198","author":"Tello","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102102441945000_59.6.2101454.10","doi-asserted-by":"crossref","first-page":"e006591","DOI":"10.1161\/CIRCHEARTFAILURE.119.006591","article-title":"Effective arterial elastance in the pulmonary arterial circulation: derivation, assumptions, and clinical applications","volume":"13","author":"Brener","year":"2020","journal-title":"Circ Heart Fail"},{"key":"2024102102441945000_59.6.2101454.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.068"},{"key":"2024102102441945000_59.6.2101454.12","doi-asserted-by":"crossref","first-page":"3196","DOI":"10.1038\/s41598-017-03377-6","article-title":"Reference value of left and right atrial size and phasic function by SSFP CMR at 3.0T in healthy Chinese adults","volume":"7","author":"Li","year":"2017","journal-title":"Sci Rep"},{"key":"2024102102441945000_59.6.2101454.13","doi-asserted-by":"crossref","first-page":"e008582","DOI":"10.1161\/CIRCIMAGING.118.008582","article-title":"Impaired cardiovascular magnetic resonance-derived rapid semiautomated right atrial longitudinal strain is associated with decompensated hemodynamics in pulmonary arterial hypertension","volume":"12","author":"Leng","year":"2019","journal-title":"Circ Cardiovasc Imaging"},{"key":"2024102102441945000_59.6.2101454.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"2024102102441945000_59.6.2101454.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.041"},{"key":"2024102102441945000_59.6.2101454.16","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"2024102102441945000_59.6.2101454.17","doi-asserted-by":"crossref","first-page":"e006984","DOI":"10.1161\/CIRCIMAGING.117.006984","article-title":"Clinical utility and prognostic value of right atrial function in pulmonary hypertension","volume":"11","author":"Alenezi","year":"2018","journal-title":"Circ Cardiovasc Imaging"},{"key":"2024102102441945000_59.6.2101454.18","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s10554-017-1081-7","article-title":"Right atrial strain is predictive of clinical outcomes and invasive hemodynamic data in group 1 pulmonary arterial hypertension","volume":"33","author":"Bhave","year":"2017","journal-title":"Int J Cardiovasc Imaging"},{"key":"2024102102441945000_59.6.2101454.19","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ijcard.2017.08.047","article-title":"Right atrial function and prognosis in idiopathic pulmonary arterial hypertension","volume":"248","author":"D'Alto","year":"2017","journal-title":"Int J Cardiol"},{"key":"2024102102441945000_59.6.2101454.20","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.ijcard.2017.11.093","article-title":"Right atrial function in patients with pulmonary hypertension: a study with two-dimensional speckle-tracking echocardiography","volume":"255","author":"Meng","year":"2018","journal-title":"Int J Cardiol"},{"key":"2024102102441945000_59.6.2101454.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.003521"},{"key":"2024102102441945000_59.6.2101454.22","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s10554-019-01763-x","article-title":"Association of right atrial conduit phase with right ventricular lusitropic function in pulmonary hypertension","volume":"36","author":"Richter","year":"2020","journal-title":"Int J Cardiovasc Imaging"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.01454-2021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:52:32Z","timestamp":1740358352000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.01454-2021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,11]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,23]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1183\/13993003.01454-2021"],"URL":"https:\/\/doi.org\/10.1183\/13993003.01454-2021","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,11]]}}}