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Left atrium: the last bulwark before overt heart failure
Matteo Cameli1, Giulia Elena Mandoli2, Sergio Mondillo1
1Department of Cardiovascular Diseases, University of Siena, Policlinico "Le Scotte", Viale Bracci 1, 53100, Siena, Italy.
Heart Failure Reviews
|November 23, 2016
Summary
Heart failure with preserved ejection fraction (HFpEF) is common and distinct from reduced ejection fraction HF. The left atrium (LA) plays a crucial role in diastolic dysfunction and HFpEF, requiring thorough echocardiographic assessment.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Disease
Background:
- Heart failure with preserved ejection fraction (HFpEF) is the predominant form of heart failure in ambulatory settings.
- HFpEF is increasingly recognized as a distinct clinical entity separate from heart failure with reduced ejection fraction.
- The left atrium (LA) is implicated in maintaining ventricular function and patient asymptomatic status, even in early diastolic dysfunction (DD).
Purpose of the Study:
- To review the evolving understanding of the left atrium's role in diastolic dysfunction and HFpEF.
- To emphasize the significance of comprehensive LA assessment in various clinical scenarios.
- To explore the correlation between LA parameters and major cardiovascular events.
Main Methods:
- Review of current literature on left atrial function and its impact on HFpEF.
- Focus on echocardiographic techniques, particularly speckle tracking echocardiography (STE), for LA assessment.
- Analysis of LA size (volume) and function (myocardial deformation).
Main Results:
- The left atrium plays a critical role in the pathophysiology of diastolic dysfunction and HFpEF.
- Accurate assessment of LA size and function, especially using STE, is essential for a complete echocardiographic evaluation.
- LA parameters are increasingly linked to cardiovascular outcomes.
Conclusions:
- Comprehensive echocardiographic evaluation of the left atrium is vital for diagnosing and managing HFpEF.
- Understanding LA's role provides insights into disease progression and risk stratification.
- Further research into LA assessment can improve patient outcomes in HFpEF.
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