Key result
Stepwise algorithm integrates multimodality imaging and clinical traits to evaluate LA geometry and function.
Why the study?
Recent advances in imaging offer opportunities for comprehensive left atrial evaluation, prompting the need for a practical, stepwise algorithm integrating multimodality imaging and clinical approach for left atrial geometry and functional analysis.
This review emphasizes the importance of left atrial structural and functional evaluation using multimodality imaging to assess atrial cardiomyopathy in various cardiac conditions.
In recent years, new interest is growing in the left atrium (LA). LA functional analysis and measurement have an essential role in cardiac function evaluation. Left atrial size and function are key elements during the noninvasive analysis of diastolic function in several heart diseases. The LA represents a "neuroendocrine organ" with high sensitivity to the nervous, endocrine, and immune systems. New insights highlight the importance of left atrial structural, contractile, and/or electrophysiological changes, introducing the concept of "atrial cardiomyopathy", which is closely linked to underlying heart disease, arrhythmias, and conditions such as aging. The diagnostic algorithm for atrial cardiomyopathy should follow a stepwise approach, combining risk factors, clinical characteristics, and imaging. Constant advances in imaging techniques offer superb opportunities for a comprehensive evaluation of LA function, underlying specific mechanisms, and patterns of progression. In this literature review, we aim to suggest a practical, stepwise algorithm with integrative multimodality imaging and a clinical approach for LA geometry and functional analysis. This integrates diastolic flow analysis with LA remodelling by the application of traditional and new diagnostic imaging techniques in several clinical settings such as heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), and mitral regurgitation (MR).
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Beltrami et al. (2022) conducted a review in Atrial cardiomyopathy, heart failure, atrial fibrillation, coronary artery disease, and mitral regurgitation. Integrative multimodality imaging and clinical approach was evaluated. A practical, stepwise algorithm integrating multimodality imaging and clinical characteristics is proposed for the comprehensive evaluation of left atrial geometry and function in various heart diseases.
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