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Heart Failure Clinics Apr 2019Left atrial size and function parameters are associated with adverse outcomes in multiple disease states, including heart failure with reduced and preserved ejection... (Review)
Review
Left atrial size and function parameters are associated with adverse outcomes in multiple disease states, including heart failure with reduced and preserved ejection fraction. Recent data suggest that phasic left atrial function and left atrial stain measurements also hold prognostic information. Three-dimensional echocardiography provides more accurate and reproducible quantification of left atrial volumes than 2-dimensional echocardiography when compared with cardiac magnetic resonance reference standards. Greater accessibility to these advanced imaging techniques allows for the integration of these parameters into routine clinical practice.
Topics: Atrial Function, Left; Echocardiography; Heart Atria; Heart Failure; Humans
PubMed: 30832811
DOI: 10.1016/j.hfc.2018.12.001 -
Acta Medica Indonesiana Jan 2022Heart failure is the end of all pathological conditions in the heart. Most accepted paradigms in heart failure are always preceded by left ventricle disfunction.... (Review)
Review
Heart failure is the end of all pathological conditions in the heart. Most accepted paradigms in heart failure are always preceded by left ventricle disfunction. Currently, there are several clinical studies that show that heart failure may occur without prior left ventricular dysfunction. Left atrial dysfunction may play a more important role in heart failure than previously expected. Failure of the left atrium can exist independently of left ventricle dysfunction and mitral valve abnormalities. Atrial failure, just like left ventricular failure, can lead to global heart failure. Etiology, pathomechanism and clinical symptoms of atrial failure are complex and not well understood. This review will explain atrial failure.
Topics: Heart Atria; Heart Failure; Humans; Mitral Valve; Ventricular Dysfunction, Left
PubMed: 35398835
DOI: No ID Found -
Journal of the American Heart... Mar 2018
Topics: Atrial Fibrillation; Atrial Function, Left; Cardiovascular Diseases; Heart Atria; Humans; Risk Factors
PubMed: 29602765
DOI: 10.1161/JAHA.118.008930 -
Journal of the American College of... Dec 2017Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an... (Review)
Review
Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an important underlying substrate for AF and stroke. LA dilation and dysfunction form a prothrombotic milieu characterized by blood stasis and endothelial dysfunction. In addition, alterations of the atrial cardiomyocytes, increase of noncollagen deposits in the interstitial space and fibrosis, favor the occurrence of re-entry that predisposes to AF. Eventually, AF further impairs LA function and promotes LA remodeling, closing a self-perpetuating vicious circle. Multimodality imaging provides a comprehensive evaluation of several aspects of LA remodeling and offers several parameters to identify patients at risk of AF and stroke. How multimodality imaging can be integrated in clinical management of patients at risk of AF and stroke is the focus of the present review paper.
Topics: Atrial Appendage; Atrial Fibrillation; Atrial Function, Left; Atrial Remodeling; Global Health; Heart Atria; Humans; Incidence; Multimodal Imaging; Stroke
PubMed: 29268928
DOI: 10.1016/j.jacc.2017.10.063 -
JACC. Cardiovascular Imaging Jan 2017The left atrium is considered a biomarker for adverse cardiovascular outcomes, particularly in patients with left ventricular diastolic dysfunction and atrial... (Review)
Review
The left atrium is considered a biomarker for adverse cardiovascular outcomes, particularly in patients with left ventricular diastolic dysfunction and atrial fibrillation in whom left atrial (LA) enlargement is of prognostic importance. LA enlargement with a consequent decrease in LA function represents maladaptive structural and functional "remodeling" that in turn promotes electrical remodeling and a milieu conducive for incident atrial fibrillation. Medical and nonmedical interventions may arrest this pathophysiologic process to the extent that subsequent reverse remodeling results in a reduction in LA size and improvement in LA function. This review examines cellular and basic mechanisms involved in LA remodeling, evaluates the noninvasive techniques that can assess these changes, and examines potential mechanisms that may initiate reverse remodeling.
Topics: Animals; Atrial Fibrillation; Atrial Function, Left; Atrial Remodeling; Cardiac Imaging Techniques; Fibrosis; Heart Atria; Humans; Predictive Value of Tests; Recovery of Function; Risk Factors; Treatment Outcome; Ventricular Dysfunction, Left; Ventricular Function, Left
PubMed: 28057220
DOI: 10.1016/j.jcmg.2016.11.003 -
Kardiologia Polska 2021The speckle-tracking technique has become an easily accessible, quick-to-use, and straightforward tool for assessing advanced myocardial function. Achievements in the... (Review)
Review
The speckle-tracking technique has become an easily accessible, quick-to-use, and straightforward tool for assessing advanced myocardial function. Achievements in the analysis of the left atrium have demonstrated that it plays an important role in the physiology and pathophysiology of the circulatory system. Deformation analysis allows the detection of even subtle functional abnormalities when atrial enlargement is not yet detected. Thus, left atrial strain has a documented diagnostic and prognostic value in many clinical scenarios. Furthermore, this technique is increasingly entering routine clinical practice. The analysis becomes possible thanks to new tools that simplify the speckle-tracking assessment. Left atrial strain improves diagnostic possibilities of standard echocardiographic examination, and its diagnostic and prognostic value is sometimes comparable with more advanced and less available techniques. In this review, we discuss the principles of performing strain analysis and the results of current research, and thus the potential possibilities of sophisticated atrial assessment application in various clinical scenarios.
Topics: Atrial Appendage; Echocardiography; Heart Atria; Humans
PubMed: 34599503
DOI: 10.33963/KP.a2021.0105 -
Europace : European Pacing,... Jun 2023Atrial fibrillation is associated with neurocognitive comorbidities such as stroke and dementia. Evidence suggests that rhythm control-especially if implemented... (Review)
Review
Atrial fibrillation is associated with neurocognitive comorbidities such as stroke and dementia. Evidence suggests that rhythm control-especially if implemented early-may reduce the risk of cognitive decline. Catheter ablation is highly efficacious for restoring sinus rhythm in the setting of atrial fibrillation; however, ablation within the left atrium has been shown to result in MRI-detected silent cerebral lesions. In this state-of-the-art review article, we discuss the balance of risk between left atrial ablation and rhythm control. We highlight suggestions to lower the risk, as well as the evidence behind newer forms of ablation such as very high power short duration radiofrequency ablation and pulsed field ablation.
Topics: Humans; Atrial Fibrillation; Catheter Ablation; Heart Atria; Radiofrequency Ablation; Stroke
PubMed: 37306314
DOI: 10.1093/europace/euad151 -
Journal of the American Society of... Aug 2020Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions.... (Review)
Review
Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions. Moreover, noninvasive evaluation of LA pressure has gained importance in the characterization of the hemodynamic profile of patients. This review describes the methodology, benefits and pitfalls of measuring LA size and function by echocardiography and provides a brief overview of the prognostic utility of newer echocardiographic metrics of LA geometry and function (i.e., three-dimensional volumes, longitudinal strain, and phasic function parameters).
Topics: Atrial Appendage; Atrial Function, Left; Echocardiography; Heart Atria; Humans; Prognosis
PubMed: 32762920
DOI: 10.1016/j.echo.2020.03.021 -
European Journal of Heart Failure Nov 2016The left atrium plays an important role in the maintenance of cardiovascular and neurohumoral homeostasis in heart failure. However, with progressive left ventricular... (Review)
Review
The left atrium plays an important role in the maintenance of cardiovascular and neurohumoral homeostasis in heart failure. However, with progressive left ventricular dysfunction, left atrial (LA) dilation and mechanical failure develop, which frequently culminate in atrial fibrillation. Moreover, LA mechanical failure is accompanied by LA endocrine failure [deficient atrial natriuretic peptide (ANP) processing-synthesis/development of ANP resistance) and LA regulatory failure (dominance of sympathetic nervous system excitatory mechanisms, excessive vasopressin release) contributing to neurohumoral overactivity, vasoconstriction, and volume overload (global LA failure). The purpose of the present review is to describe the characteristics and emphasize the clinical significance of global LA failure in patients with heart failure.
Topics: Atrial Fibrillation; Atrial Function, Left; Atrial Natriuretic Factor; Heart Atria; Heart Failure; Humans; Sympathetic Nervous System; Vasoconstriction; Vasopressins; Ventricular Dysfunction, Left
PubMed: 27813305
DOI: 10.1002/ejhf.645 -
JACC. Cardiovascular Imaging Jan 2021
Topics: Atrial Fibrillation; Heart Atria; Heart Failure; Humans; Predictive Value of Tests
PubMed: 33413884
DOI: 10.1016/j.jcmg.2020.09.012