A total of 125 people were recruited for the study. The number of patients in the preserved EF group (EF≥50%) was 45 and in the reduced EF group (EF<50%) was 80 patients. In the analysis of the above two groups, in terms of the average age and gender of the patients, no significant difference was observed between the two groups (p-value=0.90 and-value=0.89, respectively). A comparison of LVEDP invasively measured by the catheter during angiography showed a significant difference between the two groups (P-value<0.001). It was demonstrated, by a comparison of the two groups, that there were significant differences in terms of diastolic dysfunction indices, including septal and lateral e', left atrial volume index (LAVI), and right ventricular systolic pressure (RVSP) (Table 1). However, evaluation of E/é, LVEDV, E/A, and DT showed no significant difference between the above two groups (Table 1). Comparison LA-reservoir and LA-booster strain of the two groups with preserved EF and with reduced EF, a significant difference was observed (P-value=0.008, mean Reservoir=19.5%±5.6, mean Reservoir=16.4%±6.4, respectively) and (P-value=0.009, mean Booster =11. 9%±4.3, mean Booster =9.09%±4.0, respectively).

The average LVEF in the group with preserved EF (i.e., LVEF≥50%) was 55% and in the group with reduced EF (i.e., LVEF<50%) was 20%.

In the assessment of LV diastolic dysfunction severity based on common criteria, no significant difference was observed between the above two groups (P-value=0.168). In terms of the history of myocardial infarction (MI) and the number of significant coronary artery stenosis, there was a significant difference between the two groups(P-value<0.001 and P-value<0.001, respectively). No significant difference was observed between the two groups in terms of MR severity (P-value=0.58).

**Sub-group analysis**

In the sub-group analysis based on the level of LVEDP equal to or greater than 20 mmHg and less than 20 mmHg, the number of patients in the LVEDP≥ 20mmHg group was 17 and in the LVEDP<20mmHg group was 118.ComparingLAS between these two groups (with LVEDP≥20mmHg and with LVEDP<20mmHg), showed a significant difference in LA-reservoir values (P-value=0.007, mean LA-reservoir=14.0%±5.5, mean LA-reservoir=18.1%±6.2, respectively). LA-booster strain evaluation between the two groups showed that the value of the mean 4ch-booster also had a significant difference. But no significant difference was observed between the two groups in the evaluation of the mean 2ch-booster (P-value=0.01, P-value=0.10, respectively). A number of other echocardiographic modalities related to diastolic dysfunction showed a significant difference between the two mentioned groups including E/A ratio and DT (P-value=0.025 and P-value<0.001, respectively), but evaluation of é values in the septum and lateral region, the E/é ratio, LVEDV, and LAVI, didn’t show a significant difference. (P-value=0.01, P-value=0.10, respectively) (Table 2). Also, in the evaluation of the two groups, no significant difference was observed in terms of the history of myocardial infarction and the number of significant coronary artery stenosis (P-value=0.645 and P-value=0.319 respectively). In the patients with LVEDP≥ 20mmHg, the average EF was equal to 37.5%±9.0% and in the LVEDP<20 mmHg group, the average EF was equal to 43.3%±8.4% which showed a significant difference (P-value=0.003). There was no significant difference between the two groups in terms of gender.

The cut-off value of LA-reservoir strain to estimate LVEDP above≥20mmHg was analyzed with a receiver-operating curve (ROC). Mean LA-reservoir cut-off <12.4% can determine LVEDP≥ 20mmHg with a sensitivity of 83.7% and specificity of 65%. Also, LA 4ch-reservoir<14.4%, and LA 2ch-reservoir<14.1% can determine LVEDP≥20mmHg (sensitivity 63.5% and specificity 75%) (sensitivity 77.9% and specificity of 60%) respectively (Figures 1 a, b, and c).