ArticleJournal of clinical hypertension (Greenwich, Conn.)2026
Left Atrial Reservoir Strain Combined With Left Ventricular Longitudinal Strain Improves Discrimination of HFpEF in Patients With Hypertension.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Early identification of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients remains challenging using conventional parameters alone. This retrospective study aimed to assess whether combining left atrial (LA) reservoir strain (εs) with left ventricular (LV) longitudinal strain improves the discrimination of HFpEF among hypertensive patients. We included 50 hypertensive patients with HFpEF (HTN-HFpEF), 56 hypertensive patients without HFpEF, and 50 healthy controls. Cardiac magnetic resonance feature tracking (CMR-FT) was used to measure LV global longitudinal strain (LVGPLS) and strain rates, as well as LA εs, conduit (εe), and booster (εa) strains. Parameters were compared across the three groups. Binary logistic regression was performed to identify predictors of HTN-HFpEF, and receiver operating characteristic (ROC) curves were generated to calculate the area under the curve (AUC). From controls to HTN to HTN-HFpEF, LVGPLS and strain rate showed progressive impairment, while LAVImax and LAVImin progressively increased (all p < 0.001). Compared to the HTN group and healthy controls, the HTN-HFpEF group demonstrated significant impairment in LA functional and strain parameters (all p < 0.001). Binary logistic regression analyses revealed that LVMI, LAVImin, LAεs, and LVGPLS remained independently associated with HFpEF. LAεs alone showed the highest diagnostic performance (AUC = 0.790), and the combination of LAεs and LVGPLS further improved the AUC to 0.841. In conclusion, CMR-FT-derived LA strain demonstrates high discriminative ability for HFpEF in hypertensive patients. The combination of LAεs and LVGPLS offers optimal diagnostic value and may serve as a sensitive non-invasive biomarker for identifying HFpEF in this population.
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