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Heart Failure Reviews

, Volume 24, Issue 5, pp 661–669 | Cite as

The left atrium and the right ventricle: two supporting chambers to the failing left ventricle

  • Matteo Cameli
  • Maria Concetta PastoreEmail author
  • Michael Y. Henein
  • Sergio Mondillo
Article
  • 159 Downloads

Abstract

Heart failure (HF) is mainly caused by left ventricular (LV) impairment of function, hence detailed assessment of its structure and function is a clinical priority. The frequent involvement of the left atrium (LA) and the right ventricle (RV) in the overall cardiac performance has recently gained significant interest with specific markers predicting exercise intolerance and prognosis being proposed. The LA and RV are not anatomically separated from the LV, while the LA controls the inlet the RV shares the interventricular septum with the LV. Likewise, the function of the two chambers is not entirely independent from that of the LV, with the LA enlarging to accommodate any rise in filling pressures, which could get transferred to the RV via the pulmonary circulation. In the absence of pulmonary disease, LA and RV function may become impaired in patients with moderate-severe LV disease and raised filling pressures. These changes can often occur irrespective of the severity of systolic dysfunction, thus highlighting the important need for critical assessment of the function of the two chambers. This review evaluates the pivotal role of the left atrium and right ventricle in the management of HF patients based on the available evidence.

Keywords

Heart failure Left atrium Right ventricle Prognosis Echocardiography 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1.Department of Cardiovascular DiseasesUniversity of SienaSienaItaly
  2. 2.Department of Public Health and Clinical MedicineUmeå University and Heart CentreUmeåSweden

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