Westmead Hospital, Westmead Clinical School at University of Sydney and South West Sydney Clinical School at University of NSW, Sydney, Australia.
Canberra Hospital, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
JACC Cardiovasc Imaging. 2017 Jan;10(1):65-77. doi: 10.1016/j.jcmg.2016.11.003.
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.
左心房被认为是不良心血管结局的生物标志物，特别是在左心室舒张功能障碍和心房颤动患者中，左心房（LA）增大具有重要的预后意义。LA 增大导致 LA 功能下降代表适应性不良的结构和功能“重塑”，进而促进电重塑和有利于发生心房颤动的环境。医疗和非医疗干预措施可能会阻止这一病理生理过程，从而使随后的逆重构导致 LA 大小减小和 LA 功能改善。本综述检查了涉及 LA 重塑的细胞和基本机制，评估了可评估这些变化的非侵入性技术，并研究了可能引发逆重构的潜在机制。
