Conclusion
Our study demonstrated the deterioration of 2DSTE-derived LA functions along with the advanced grades of diastolic dysfunction. The decrease in LA pump function in Grade 3 diastolic dysfunction is evident and it may be associated with the extent of LA remodeling and fibrosis in these patients. The strong correlation of the echocardiographic pulmonary vascular resistance estimates with the LA strain parameters, and their association with the diastolic dysfunction grades may inspire future studies in HFpEF patients.