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).