Key result
Left atrial filling index is elevated in hypertension and correlates positively with E/e' and BNP.
Why the study?
Early impairment of LA compliance and mechanics reflects LV filling pressures over time and often precedes overt chamber enlargement or symptomatic heart failure. This study evaluated the diagnostic value of the LA filling index (E/LARS ratio) and its correlation with BNP as a surrogate for LV filling pressures in hypertensive patients with preserved EF.
Does the left atrial filling index (E/LA reservoir strain ratio) correlate with brain natriuretic peptide (BNP) and left ventricular filling pressures in hypertensive patients with preserved ejection fraction?
Case-Control (n=91)
Does the left atrial filling index (E/LA reservoir strain ratio) correlate with brain natriuretic peptide (BNP) and left ventricular filling pressures in hypertensive patients with preserved ejection fraction?
The E/LA strain ratio is a promising noninvasive echocardiographic marker that correlates with BNP and E/e' for detecting subclinical atrial myopathy and elevated LV filling pressures in hypertensive patients with preserved ejection fraction.
Answers are grounded in this paper and cite their sources.
May signal early filling pressure changes in hypertension; extends atrial strain research but leaves open clinical utility.
Context: The left atrium (LA) is no longer viewed as a passive transport chamber but as a sensitive barometer that reflects LV filling pressures over time, so early impairment of atrial compliance and mechanics often precedes overt chamber enlargement or symptomatic heart failure. Aim: To evaluate the diagnostic value of the left atrial (LA) filling index (E/LA reservoir strain [LARS] ratio) and its correlation with brain natriuretic peptide (BNP) as a surrogate for left ventricle (LV) filling pressures in hypertensive patients with preserved ejection fraction (EF). Methods: A case-control study was conducted on 91 participants: Group I ( n = 35, hypertensive patients without left ventricular hypertrophy (LVH), Group II ( n = 36, hypertensive with LVH), and Group III ( n = 20, healthy controls). All participants underwent Two-dimensional-speckle tracking echocardiography using a GE Vivid E95 system to assess LA phasic mechanics. The LA filling index was calculated as E-wave velocity divided by LARS. Results: LA reservoir and conduit strain were significantly impaired in both hypertensive groups compared to controls ( P < 0.001). The LA filling index was significantly higher in hypertensive patients, particularly those with LVH ( P < 0.001). A significant positive correlation was found between the LA filling index and both the E/e’ ratio ( r = 0.420, P < 0.001) and BNP levels ( r = 0.378, P < 0.001). Conclusion: The E/LA strain ratio appears to be a promising, noninvasive marker for detecting subclinical atrial myopathy and elevated LV filling pressures in hypertensive heart disease, even before overt structural remodeling occurs.
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Noamany et al. (2026) conducted a case-control in Hypertension with preserved ejection fraction (n=91). Left atrial filling index (E/LA reservoir strain ratio) via 2D speckle-tracking echocardiography vs. Healthy controls was evaluated on Left atrial filling index (E/LA reservoir strain ratio) and its correlation with E/e' ratio and BNP levels (r = 0.378 (for BNP); r = 0.420 (for E/e'), p=<0.001). The left atrial filling index was significantly elevated in hypertensive patients vs controls (P<0.001) and correlated positively with E/e' (r=0.420, P<0.001) and BNP (r=0.378, P<0.001).
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