Defining left atrial (LA) function has recently emerged as a powerful parameter, particularly in evaluation of left ventricular (LV) diastolic dysfunction (LVDD) and heart failure with preserved ejection fraction. Echocardiographic assessment of LVDD by echocardiography remains a challenging task; recent recommendations provide a simpler approach than previous. However, the shortcomings of the proposed approach (including transmitral flow, tissue velocity, maximum left atrial volume [LAV], and estimated pulmonary artery systolic pressure), lead to the presence and severity of LVDD remaining undetermined in a significant proportion of patients. Maximum LAV is a surrogate measure of the chronicity and severity of LVDD, but LAV alone is an insensitive biomarker of early phases of LVDD, because the LA may take time to remodel. Because the primary function of the LA is to modulate LV filling, it is not surprising that functional LA changes become evident at the earliest stages of LVDD. Moreover, LA function may provide additive value, not only in diagnosing LVDD, but also in grading its severity and in monitoring the effects of treatment. The current review provides a critical appraisal on the existing evidence for the role of LA metrics in evaluation of LVDD and consequent heart failure with preserved ejection fraction.

Thomas, L., Marwick, T., Popescu, B., Donal, E., Badano, L. (2019). Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 73(15), 1961-1977 [10.1016/j.jacc.2019.01.059].

Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review

Badano, L
2019

Abstract

Defining left atrial (LA) function has recently emerged as a powerful parameter, particularly in evaluation of left ventricular (LV) diastolic dysfunction (LVDD) and heart failure with preserved ejection fraction. Echocardiographic assessment of LVDD by echocardiography remains a challenging task; recent recommendations provide a simpler approach than previous. However, the shortcomings of the proposed approach (including transmitral flow, tissue velocity, maximum left atrial volume [LAV], and estimated pulmonary artery systolic pressure), lead to the presence and severity of LVDD remaining undetermined in a significant proportion of patients. Maximum LAV is a surrogate measure of the chronicity and severity of LVDD, but LAV alone is an insensitive biomarker of early phases of LVDD, because the LA may take time to remodel. Because the primary function of the LA is to modulate LV filling, it is not surprising that functional LA changes become evident at the earliest stages of LVDD. Moreover, LA function may provide additive value, not only in diagnosing LVDD, but also in grading its severity and in monitoring the effects of treatment. The current review provides a critical appraisal on the existing evidence for the role of LA metrics in evaluation of LVDD and consequent heart failure with preserved ejection fraction.
Articolo in rivista - Articolo scientifico
2-dimensional echocardiography; 3-dimensional echocardiography; heart failure with preserved ejection fraction; left atrial fibrosis; left atrium; left ventricular diastolic function; phasic function; speckle-tracking echocardiography; volumes;
2-dimensional echocardiography; 3-dimensional echocardiography; heart failure with preserved ejection fraction; left atrial fibrosis; left atrium; left ventricular diastolic function; phasic function; speckle-tracking echocardiography; volumes
English
2019
73
15
1961
1977
reserved
Thomas, L., Marwick, T., Popescu, B., Donal, E., Badano, L. (2019). Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction: JACC State-of-the-Art Review. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 73(15), 1961-1977 [10.1016/j.jacc.2019.01.059].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/244417
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