Introduction
While left atrial (LA) function could play a significant role in patients affected by cardiovascular diseases, it is poorly studied in several pathological conditions and is frequently considered a passive bystander of these pathophysiologic alterations [1]. However, the LA is a complex and active chamber which modulates left ventricle filling during ventricular systole through its reservoir function and during ventricular diastole as a conduit and booster pump functions [1–3]. Moreover, the interplay between LA and left ventricular (LV) functions throughout the cardiac cycle is crucial in several pathophysiological conditions [3, 4].
Recently, using two-dimensional spackle tracking evaluation (2D-STE), the significance of LA function impairment in heart failure has been demonstrated [5, 6]. However, the predictive value of the different phases of atrial function – i.e. reservoir, conduit, and contraction – still needs to be clarified. Moreover, the combination between the LA reservoir and Doppler measures of diastolic function has been demonstrated to be more accurate in detecting the presence of high LV filling pressure [7], but its association with heart failure outcome has not been investigated.
The aim of this study was to evaluate the role of the LA strain parameters reflecting the reservoir, conduit, and contraction as well as the combination with Doppler measurements of atrial function in predicting worsening chronic heart failure (CHF).