{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T20:35:00Z","timestamp":1774643700851,"version":"3.50.1"},"reference-count":15,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T00:00:00Z","timestamp":1674259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Left atrial hypertension is one of the pathophysiologies of heart failure with preserved ejection fraction. We hypothesized that left atrial pressure response (LAPR) to incremental pacing is higher in patients with atrial fibrillation (AF) and can predict left ventricular diastolic dysfunction. Materials and Methods: Patients requiring left atrial access as a part of a therapeutic procedure for AF (n = 204, AF group) or supraventricular tachycardia (n = 34, control group) were analyzed (male n = 183, 54 \u00b1 12 years old). LAPR was measured during incremental pacing. Results: Baseline left atrial pressure and LAPR at all pacing rates were not different between the AF and control groups. They were higher in patients with a high E\/e\u2019 (\u2265 8) than in those with a low E\/e\u2019 (&lt;8). LAPR at a pacing interval of 400 ms and E\/e\u2019 were positively correlated (r = 0.373, p &lt; 0.001). Body mass index and a high E\/e\u2019 were independent predictors of pacing-induced left atrial hypertension. Conclusions:\u00a0LAPR to incremental pacing was constant regardless of AF. The non-invasive echocardiographic marker E\/e\u2019 reflected pacing-induced left atrial hypertension.<\/jats:p>","DOI":"10.3390\/medicina59020210","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T02:27:45Z","timestamp":1674440865000},"page":"210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["E\/e\u2019 Ratio Predicts the Atrial Pacing-Induced Left Atrial Pressure Response in Patients with Preserved Ejection Fraction"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0854-9079","authenticated-orcid":false,"given":"Seung-Young","family":"Roh","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-In","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungju-si 28644, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7430-415X","authenticated-orcid":false,"given":"Kwang-No","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhee","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Pusan National University Hsopital, Busan 49241, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6086-0446","authenticated-orcid":false,"given":"Yong-Soo","family":"Baek","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon 22332, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6339-8496","authenticated-orcid":false,"given":"Dong-Hyeok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Ewha University Hospital, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-1522","authenticated-orcid":false,"given":"Jaemin","family":"Shim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-508X","authenticated-orcid":false,"given":"Jong-Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1161\/01.CIR.98.21.2282","article-title":"Congestive heart failure in the community: A study of all incident cases in Olmsted County, Minnesota, in 1991","volume":"98","author":"Senni","year":"1998","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1016\/S0735-1097(99)00118-7","article-title":"Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: Prevalence and mortality in a population-based cohort","volume":"33","author":"Vasan","year":"1999","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2810","DOI":"10.1093\/eurheartj\/ehy268","article-title":"Haemodynamics, dyspnoea, and pulmonary reserve in heart failure with preserved ejection fraction","volume":"39","author":"Obokata","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.hrthm.2014.03.009","article-title":"High left atrial pressures are associated with advanced electroanatomical remodeling of left atrium and independent predictors for clinical recurrence of atrial fibrillation after catheter ablation","volume":"11","author":"Park","year":"2014","journal-title":"Heart Rhythm"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1161\/01.CIR.0000086979.39843.7B","article-title":"Intra-atrial pressure increases rate and organization of waves emanating from the superior pulmonary veins during atrial fibrillation","volume":"108","author":"Kalifa","year":"2003","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jacep.2017.02.002","article-title":"Left Atrial Hypertension in Atrial Fibrillation: Dealing with the Pressure","volume":"3","author":"Markowitz","year":"2017","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ehjci\/jew082","article-title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/j.jacc.2019.01.059","article-title":"Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review","volume":"73","author":"Thomas","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1016\/S0735-1097(02)02373-2","article-title":"Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women","volume":"40","author":"Tsang","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/S0002-9149(03)00152-8","article-title":"Doppler transmitral flow indexes and risk of atrial fibrillation (the Framingham Heart Study)","volume":"91","author":"Vasan","year":"2003","journal-title":"Am. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.echo.2004.08.033","article-title":"Diastolic stress echocardiography: A novel noninvasive diagnostic test for diastolic dysfunction using supine bicycle exercise Doppler echocardiography","volume":"18","author":"Ha","year":"2005","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1002\/ejhf.957","article-title":"Echocardiographic estimation of left ventricular and pulmonary pressures in patients with heart failure and preserved ejection fraction: A study utilizing simultaneous echocardiography and invasive measurements","volume":"19","author":"Hummel","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1016\/j.jacc.2006.02.042","article-title":"Diastolic stress echocardiography: Hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise","volume":"47","author":"Burgess","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.jcmg.2011.07.004","article-title":"Serial Doppler echocardiography and tissue Doppler imaging in the detection of elevated directly measured left atrial pressure in ambulant subjects with chronic heart failure","volume":"4","author":"Ritzema","year":"2011","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1093\/europace\/eux119","article-title":"An E\/e\u2019 ratio on echocardiography predicts the existence of left atrial low-voltage areas and poor outcomes after catheter ablation for atrial fibrillation","volume":"20","author":"Masuda","year":"2018","journal-title":"Europace"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:12:53Z","timestamp":1760119973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/2\/210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,21]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["medicina59020210"],"URL":"https:\/\/doi.org\/10.3390\/medicina59020210","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,21]]}}}