Assessment of left atrial function: Another window to detect early cardiac impairment?

Abstract

The article by Tadic and colleagues 1 in this issue of the Journal draws attention to the importance of identifying early evidence for cardiac involvement in hypertension.The most common structural alteration of the left atrium is left atrial (LA) enlargement, which has been considered a biomarker for ad- organ damage, such as LV hypertrophy and diastolic dysfunction. 8-10Recently, several studies reported that nondipper status was also associated with LA functional alteration. 4,11 Similar to nondipper status, the average nighttime BP has also been shown to be associated with cardiovascular subclinical organ damage and events. 12Moreover, average nighttime BP has been suggested to be superior to average daytime BP in terms of prognostic significance. 13,14A recent study showed that patients with normal daytime BP but abnormal nighttime BP presented high risk of mortality. 15 A new term called isolated nocturnal hypertension was proposed to emphasize the importance of the significance of the nighttime BP level.

Evaluation of LA Dynamics: a Classical Yet Still Challenging Topic until Now

“…In clinical practice, echocardiography is the most common assessment tool because of its simplicity, safety, and ability to image in real time with high temporal resolution. 6) Normally, LA function is assessed using 2-dimensional echocardiography through volumetric analysis, spectral Doppler, tissue Doppler, strain, and strain rate imaging. 7) 8) 9) 10) 11) However, not all methods produce perfect numerical representations of LA functions.…”