Left Atrial Reverse Remodeling: Mechanisms, Evaluation, and Clinical Significance

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• 作者：Liza Thomas ; MBBS ; PhD^a ; ^{l.thomas@unsw.edu.au} ; Walter P. Abhayaratna ; MBBS ; PhD^b
• 关键词：functional remodeling ; left atrium ; reverse remodeling ; structural remodeling
• 刊名：JACC: Cardiovascular Imaging
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：10
• 期：1
• 页码：65-77
• 全文大小：1441 K
• 卷排序：10

文摘

The left atrium is considered a biomarker for adverse cardiovascular outcomes, particularly in patients with left ventricular diastolic dysfunction and atrial fibrillation in whom left atrial (LA) enlargement is of prognostic importance. LA enlargement with a consequent decrease in LA function represents maladaptive structural and functional “remodeling” that in turn promotes electrical remodeling and a milieu conducive for incident atrial fibrillation. Medical and nonmedical interventions may arrest this pathophysiologic process to the extent that subsequent reverse remodeling results in a reduction in LA size and improvement in LA function. This review examines cellular and basic mechanisms involved in LA remodeling, evaluates the noninvasive techniques that can assess these changes, and examines potential mechanisms that may initiate reverse remodeling.