What is the atrium trying to tell us?

This editorial refers to ‘Left atrial structure and function and clinical outcome in the general population’[†][1], by S. Gupta et al. , on page 278 Since left atrial (LA) enlargement per se was found to be associated with mortality and with cardiovascular events1 ∼20 years ago, advances in imaging technology have given substantial support to the study of LA complex morphology and function and to its interplay with left ventricular function. Moving from M-mode LA diameters to 2D measurements, LA volume has allowed better estimates of LA size. Accordingly, early studies tested the prognostic value of LA size, assessed mainly as LA maximal volume (LAmax), in patients with different cardiovascular diseases and in the general population ( Table 1 ). The relationship to cardiovascular outcomes is expected given the fact that LA enlargement is the consequence of two factors, pressure and volume overload, which occur in a variety of cardiac disorders. In the last few years, advances in imaging techniques, such as tissue Doppler, strain, and speckle strain, have allowed the more accurate evaluation of LA function which may become a better marker of cardiovascular risk than volumes. View this table:Table 1 Left atrial maximal volume and left atrial emptying fraction as predictors … [1]: #fn-2