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Estimated left ventricular end diastolic pressure by mean left atrial transit time predicts adverse clinical outcome

J Jane Cao1,2, Karli Pipitone1, Jonathan Weber1

  • 1DeMatteis Cardiovascular Institute & Division of Cardiovascular Imaging, St. Francis Hospital & Heart Center, 100 Port Washington Blvd, Roslyn, NY 11576, USA.

European Heart Journal. Cardiovascular Imaging
|November 26, 2025
PubMed

Insights

Mean left atrial transit time (LATT) predicts left ventricular end diastolic pressure (LVEDP) and is linked to adverse outcomes. Elevated LATT indicates higher LVEDP, increasing heart failure and death risk.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomarkers

Background:

  • Left atrial transit time (LATT) correlates with left ventricular end diastolic pressure (LVEDP).
  • Elevated LVEDP is associated with adverse clinical outcomes and specific biomarkers.
  • Assessing LVEDP non-invasively is clinically significant.

Purpose of the Study:

  • To investigate the relationship between prolonged LATT and biomarkers of elevated LVEDP.
  • To determine if LATT-derived LVEDP predicts adverse cardiovascular outcomes.
  • To validate LATT as a non-invasive measure of LVEDP.

Main Methods:

  • Prospective study of 563 subjects, including 15 normal controls.
  • Cardiovascular magnetic resonance (CMR) with dynamic contrast used to assess LATT and predict LVEDP (pLVEDP).
  • Correlation with invasive LVEDP and assessment of biomarkers (NT-proBNP, LA reservoir strain, LV longitudinal strain).

Main Results:

  • pLVEDP strongly correlated with invasive LVEDP (r=0.83).
  • Elevated pLVEDP associated with higher NT-proBNP, lower LA reservoir strain, and lower LV longitudinal strain.
  • Elevated pLVEDP was an independent predictor of composite outcomes (heart failure hospitalization or death), with HRs of 2.10 and 4.33 for moderate and severe elevations, respectively.

Conclusions:

  • LATT-derived pLVEDP accurately reflects invasive LVEDP.
  • LATT is a valuable non-invasive tool for assessing LVEDP and associated biomarkers.
  • Elevated LVEDP, identified by LATT, signifies a significant long-term risk for adverse cardiovascular events.
Abstract

Keywords:
cardiac MRIcentral circulation transit timeheart failureleft atrial transit timepulmonary transit time

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