Benjamin Mina M, Rabbat Mark G
Cardiology Division, Saint Louis University Hospital, St Louis, Missouri, USA.
Department of Cardiology, Loyola University Medical Center, Maywood, Illinois, USA.
Echocardiography. 2025 Feb;42(2):e70088. doi: 10.1111/echo.70088.
The left atrium (LA) is pivotal in cardiac hemodynamics, serving as a dynamic indicator of left ventricular (LV) compliance and diastolic function. The LA undergoes structural and functional adaptations in response to hemodynamic stress, infiltrative processes, myocardial injury, and arrhythmic triggers. Remodeling of the LA in response to these stressors directly impacts pulmonary circulation, eventually leading to pulmonary capillary involvement, pulmonary artery hypertension, and eventually right ventricular failure. LA dysfunction and fibrosis also contribute to the future risk of atrial arrhythmias and mitral regurgitation. The parameters of LA size and function are being recognized as robust markers for the progression of several cardiac pathologies as well as important tools for prognostication. In this article, we briefly describe the different modalities and markers used to evaluate LA pathology in patients with nonischemic cardiomyopathies (NICM). We then provide an overview of the studies that compared the association of the different LA parameters with disease severity and future prognosis. We also identify the gaps in knowledge before these LA parameters make a case for clinical adoption.
左心房（LA）在心脏血流动力学中起关键作用，是左心室（LV）顺应性和舒张功能的动态指标。左心房会因血流动力学应激、浸润性过程、心肌损伤和心律失常触发因素而发生结构和功能适应性改变。左心房对这些应激源的重塑直接影响肺循环，最终导致肺毛细血管受累、肺动脉高压，并最终导致右心室衰竭。左心房功能障碍和纤维化也会增加未来发生房性心律失常和二尖瓣反流的风险。左心房大小和功能参数正被视为多种心脏疾病进展的有力标志物以及重要的预后工具。在本文中，我们简要描述了用于评估非缺血性心肌病（NICM）患者左心房病变的不同方法和标志物。然后，我们概述了比较不同左心房参数与疾病严重程度及未来预后之间关联的研究。我们还确定了在这些左心房参数被临床采用之前的知识空白。
