Kreimer Fabienne, Gotzmann Michael
University Hospital St. Josef-Hospital Bochum, Cardiology and Rhythmology, Ruhr University Bochum, Bochum, Germany.
Front Cardiovasc Med. 2022 Jun 30;9:942385. doi: 10.3389/fcvm.2022.942385. eCollection 2022.
Left atrial cardiomyopathy (LACM) has been an ongoing focus of research for several years. There is evidence that LACM is responsible for atrial fibrillation and embolic strokes of undetermined sources. Therefore, the correct diagnosis of LACM is of clinical importance. Various techniques, including electrocardiography, echocardiography, cardiac magnetic resonance imaging, computed tomography, electroanatomic mapping, genetic testing, and biomarkers, can both identify and quantify structural, mechanical as well as electrical dysfunction in the atria. However, the question arises whether these techniques can reliably diagnose LACM. Because of its heterogeneity, clinical diagnosis is challenging. To date, there are no recommendations for standardized diagnosis of suspected LACM. However, standardization could help to classify LACM more precisely and derive therapeutic directions to improve individual patient management. In addition, uniform diagnostic criteria for LACM could be important for future studies. Combining several parameters and relating them seems beneficial to approach the diagnosis of LACM. This review provides an overview of the current evidence regarding the diagnosis of LACM, in which several potential parameters are discussed and, consequently, a proposal for a diagnostic algorithm is presented.
左心房心肌病（LACM）多年来一直是研究的重点。有证据表明，LACM是不明来源的房颤和栓塞性卒中的病因。因此，正确诊断LACM具有临床重要性。包括心电图、超声心动图、心脏磁共振成像、计算机断层扫描、电解剖标测、基因检测和生物标志物在内的各种技术，都可以识别和量化心房的结构、机械以及电功能障碍。然而，问题在于这些技术能否可靠地诊断LACM。由于其异质性，临床诊断具有挑战性。迄今为止，尚无关于疑似LACM标准化诊断的建议。然而，标准化有助于更精确地对LACM进行分类，并得出治疗方向以改善个体患者的管理。此外，LACM统一的诊断标准对未来研究可能很重要。结合多个参数并将它们联系起来似乎有助于LACM的诊断。本综述概述了目前关于LACM诊断的证据，其中讨论了几个潜在参数，并因此提出了一种诊断算法。
