Left atrial size: physiologic determinants and clinical applications.

Published

Journal Article (Review)

Left atrial (LA) enlargement has been proposed as a barometer of diastolic burden and a predictor of common cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, and cardiovascular death. It has been shown that advancing age alone does not independently contribute to LA enlargement, and the impact of gender on LA volume can largely be accounted for by the differences in body surface area between men and women. Therefore, enlargement of the left atrium reflects remodeling associated with pathophysiologic processes. In this review, we discuss the normal size and phasic function of the left atrium. Further, we outline the clinically important aspects and pitfalls of evaluating LA size, and the methods for assessing LA function using echocardiography. Finally, we review the determinants of LA size and remodeling, and we describe the evidence regarding the prognostic value of LA size. The use of LA volume for risk stratification is an evolving science. More data are required with respect to the natural history of LA remodeling in disease, the degree of LA modifiability with therapy, and whether regression of LA size translates into improved cardiovascular outcomes.

Full Text

Duke Authors

Cited Authors

  • Abhayaratna, WP; Seward, JB; Appleton, CP; Douglas, PS; Oh, JK; Tajik, AJ; Tsang, TSM

Published Date

  • June 2006

Published In

Volume / Issue

  • 47 / 12

Start / End Page

  • 2357 - 2363

PubMed ID

  • 16781359

Pubmed Central ID

  • 16781359

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

International Standard Serial Number (ISSN)

  • 0735-1097

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2006.02.048

Language

  • eng