Left atrial dysfunction as the major driver of heart failure with preserved ejection fraction syndrome

J Clin Ultrasound. 2022 Oct;50(8):1073-1083. doi: 10.1002/jcu.23318.

Abstract

Left atrial (LA) dysfunction seems to play a central role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF), is associated with disease severity and poor outcomes and potentially impacts management. Identifying LA myopathy can help guide tailored therapy for HFpEF. Echocardiography allows the accurate measurement of atrial size and function, where LA strain appears to be a sensitive measure of intrinsic LA myopathy. Several therapies and devices that decompress of left atrium are being tested for HFpEF. Further investigation is required to understand the specific atrial effects of statins, mineralocorticoid receptor antagonists, and other therapies.

Keywords: diastolic dysfunction; echocardiography; heart failure with preserved ejection fraction; left atrial dysfunction.

Publication types

  • Review

MeSH terms

  • Heart Atria / diagnostic imaging
  • Heart Failure*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors*
  • Mineralocorticoid Receptor Antagonists
  • Stroke Volume / physiology
  • Ventricular Function, Left

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Mineralocorticoid Receptor Antagonists