Heart failure & cardiomyopathies
Comparison of the 2016 American Society of Echocardiography (ASE)/EACVI and 2025 ASE guidelines for assessing left atrial pressure in patients with normal left ventricular ejection fraction
Authors' conclusion
The 2025 guidelines significantly improved the feasibility of assessing LAP and enhanced ELAP detection rates and applicability while maintaining comparable accuracy.
Study context
- Population
- Patients with normal left ventricular ejection fraction with echocardiographic data and left atrial pressure (LAP) measurementspatients with echocardiographic data and LAP measurements
- Participants
- 119 patients
- Comparison
- 2025 ASE guidelines vs 2016 ASE/EACVI guidelines
Performance
As reported in the abstract
Diagnostic performance for ELAP
| Test or model | Sensitivity | Feasibility | Specificity | Positive predictive value | Negative predictive value | Overall accuracy |
|---|---|---|---|---|---|---|
| 2025 ASE guidelines | 86.4% [75.7-93.6] | 100% [98.0-100] | 81.8% [73.8-88.2] | 72.2% [63.7-79.3] | 91.7% [85.6-95.3] | 83.4% [77.3-88.5] |
| 2016 ASE/EACVI guidelines | 54.0% [39.3-68.2] | 78.1% [72.2-84.0] | 94.8% [88.3-98.3] | 84.4% [68.9-92.9] | 79.8% [74.5-84.3] | 80.8% [73.5-86.9] |
Sensitivity
2025 ASE guidelines86.4% [75.7-93.6]
2016 ASE/EACVI guidelines54.0% [39.3-68.2]
Feasibility
2025 ASE guidelines100% [98.0-100]
2016 ASE/EACVI guidelines78.1% [72.2-84.0]
Specificity
2025 ASE guidelines81.8% [73.8-88.2]
2016 ASE/EACVI guidelines94.8% [88.3-98.3]
Positive predictive value
2025 ASE guidelines72.2% [63.7-79.3]
2016 ASE/EACVI guidelines84.4% [68.9-92.9]
Negative predictive value
2025 ASE guidelines91.7% [85.6-95.3]
2016 ASE/EACVI guidelines79.8% [74.5-84.3]
Overall accuracy
2025 ASE guidelines83.4% [77.3-88.5]
2016 ASE/EACVI guidelines80.8% [73.5-86.9]
Original publication
Comparison of the 2016 ASE/EACVI and 2025 ASE guidelines for assessing left atrial pressure in patients with normal left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. Published 2 June 2026. doi:10.
Summarised from the published abstract; every number is checked against it