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  • Title: Pulmonary hypertension due to a stiff left atrium: Speckle tracking equivalents of large V-waves.
    Author: Caravita S, Mariani D, Blengino S, Branzi G, Crotti L, Parati G.
    Journal: Echocardiography; 2018 Sep; 35(9):1464-1466. PubMed ID: 30079533.
    Abstract:
    Heart failure with preserved ejection fraction (HFpEF) is a widely heterogeneous clinical condition. Left ventricular diastolic dysfunction is the leading etiology of HFpEF, but there might be patients presenting with a predominant disease of the left atrium (LA). We report a case of HFpEF secondary to a stiff LA, in which we corroborated invasive hemodynamic assessment with LA strain analysis. Pathognomonic, tall V-waves were observed in the wedge position in the absence of mitral regurgitation and with a near-normal QRS-gated, pre-V-wave pressure, indicating that left ventricular diastolic dysfunction was not a major issue in this case. These hemodynamic findings were mirrored by very low LA strain values, compatible with a stiff and noncompliant chamber.
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