Left atrial function: pathophysiology, echocardiographic assessment, and clinical applications

The assessment of LA function provides important pathophysiological information and may be of clinical value in different settings. The accurate assessment of LA function by echocardiography has significantly improved in recent years. Differentiating intrinsic atrial dysfunction from changes in LA function secondary to LV dysfunction seems to be more accessible using the new echocardiographic techniques. The newer parameters derived from TDI or STE are less load dependent and have higher sensitivity in assessing LA function than conventional parameters. However, the lack of standardisation limits the routine use of these parameters in current clinical practice. Preliminary studies suggest that evaluation of atrial function using newer echocardiographic techniques may have important clinical implications in predicting symptom development or risk of arrhythmias in different conditions. The extent of LA remodelling reversibility with medical treatment and the impact of such changes on outcomes require further studies.