The Role of Atrial Functional Assessment in Heart Failure

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Abstract

Cardiac remodelling is a fundamental part of the heart failure syndrome, representing a common response to various pathological stimuli that result in changes in the structural and functional properties of the heart. To date, most studies in HF have focused on ventricular remodelling, and much less emphasis has been placed on atrial structural and functional changes. In reality, the left atrium modulates left ventricular filling by acting as an elastic reservoir, passive conduit, and active booster. Left atrial dysfunction and remodelling are commonly observed in patients with heart failure and altered LA diastolic and systolic properties may influence cardiac filling and output.

Recently, thanks to the development of proper technology for LA function assessment (speckle tracking echo), there is increasing recognition of the importance of LA functional assessment in heart failure patients. LA evaluation remains crucial in the prediction of the development of heart failure, irrespectively of systolic function. If heart failure is established, atrial size and function appear to be powerful predictor of clinical outcomes.

Keywords

Atrial function Heart failure Echocardiography Left atrial strain Prognosis 

Abbreviations

AF

Atrial fibrillation

CT

Computed tomography

HF

Heart failure

HFpEF

Heart failure with preserved ejection fraction

HFrEF

Heart failure with reduced ejection fraction

LA

Left atrium/left atrial

LAEF

Left atrial emptying fraction

LV

Left ventricle/left ventricular

LVEF

Left ventricular ejection fraction

MRI

Magnetic resonance imaging

PALS

Peak atrial longitudinal strain

RV

Right ventricle/right ventricular

STE

Speckle tracking echocardiography

TDI

Tissue Doppler imaging

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Cardiovascular DiseasesUniversity of SienaSienaItaly

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