Structure and Function of the Left Atrium and Left Atrial Appendage: AF and Stroke Implications

Victoria Delgado; Luigi Di Biase; Melissa Leung; Jorge Romero; Laurens F. Tops; Barbara Casadei; Nassir Marrouche; Jeroen J. Bax

doi:10.1016/j.jacc.2017.10.063

Structure and Function of the Left Atrium and Left Atrial Appendage: AF and Stroke Implications

Victoria Delgado, Luigi Di Biase, Melissa Leung, Jorge Romero, Laurens F. Tops, Barbara Casadei, Nassir Marrouche, Jeroen J. Bax

Medicine

Research output: Contribution to journal › Review article › peer-review

141 Scopus citations

Abstract

Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an important underlying substrate for AF and stroke. LA dilation and dysfunction form a prothrombotic milieu characterized by blood stasis and endothelial dysfunction. In addition, alterations of the atrial cardiomyocytes, increase of noncollagen deposits in the interstitial space and fibrosis, favor the occurrence of re-entry that predisposes to AF. Eventually, AF further impairs LA function and promotes LA remodeling, closing a self-perpetuating vicious circle. Multimodality imaging provides a comprehensive evaluation of several aspects of LA remodeling and offers several parameters to identify patients at risk of AF and stroke. How multimodality imaging can be integrated in clinical management of patients at risk of AF and stroke is the focus of the present review paper.

Original language	English (US)
Pages (from-to)	3157-3172
Number of pages	16
Journal	Journal of the American College of Cardiology
Volume	70
Issue number	25
DOIs	https://doi.org/10.1016/j.jacc.2017.10.063
State	Published - Dec 26 2017

Keywords

atrial fibrillation
left atrial appendage
left atrium
multimodality imaging
stroke

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jacc.2017.10.063

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title = "Structure and Function of the Left Atrium and Left Atrial Appendage: AF and Stroke Implications",

abstract = "Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an important underlying substrate for AF and stroke. LA dilation and dysfunction form a prothrombotic milieu characterized by blood stasis and endothelial dysfunction. In addition, alterations of the atrial cardiomyocytes, increase of noncollagen deposits in the interstitial space and fibrosis, favor the occurrence of re-entry that predisposes to AF. Eventually, AF further impairs LA function and promotes LA remodeling, closing a self-perpetuating vicious circle. Multimodality imaging provides a comprehensive evaluation of several aspects of LA remodeling and offers several parameters to identify patients at risk of AF and stroke. How multimodality imaging can be integrated in clinical management of patients at risk of AF and stroke is the focus of the present review paper.",

keywords = "atrial fibrillation, left atrial appendage, left atrium, multimodality imaging, stroke",

author = "Victoria Delgado and {Di Biase}, Luigi and Melissa Leung and Jorge Romero and Tops, {Laurens F.} and Barbara Casadei and Nassir Marrouche and Bax, {Jeroen J.}",

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T2 - AF and Stroke Implications

AU - Delgado, Victoria

AU - Di Biase, Luigi

AU - Leung, Melissa

AU - Romero, Jorge

AU - Tops, Laurens F.

AU - Casadei, Barbara

AU - Marrouche, Nassir

AU - Bax, Jeroen J.

PY - 2017/12/26

Y1 - 2017/12/26

N2 - Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an important underlying substrate for AF and stroke. LA dilation and dysfunction form a prothrombotic milieu characterized by blood stasis and endothelial dysfunction. In addition, alterations of the atrial cardiomyocytes, increase of noncollagen deposits in the interstitial space and fibrosis, favor the occurrence of re-entry that predisposes to AF. Eventually, AF further impairs LA function and promotes LA remodeling, closing a self-perpetuating vicious circle. Multimodality imaging provides a comprehensive evaluation of several aspects of LA remodeling and offers several parameters to identify patients at risk of AF and stroke. How multimodality imaging can be integrated in clinical management of patients at risk of AF and stroke is the focus of the present review paper.

AB - Atrial fibrillation (AF) and stroke are important major health problems that share common risk factors and frequently coexist. Left atrial (LA) remodeling is an important underlying substrate for AF and stroke. LA dilation and dysfunction form a prothrombotic milieu characterized by blood stasis and endothelial dysfunction. In addition, alterations of the atrial cardiomyocytes, increase of noncollagen deposits in the interstitial space and fibrosis, favor the occurrence of re-entry that predisposes to AF. Eventually, AF further impairs LA function and promotes LA remodeling, closing a self-perpetuating vicious circle. Multimodality imaging provides a comprehensive evaluation of several aspects of LA remodeling and offers several parameters to identify patients at risk of AF and stroke. How multimodality imaging can be integrated in clinical management of patients at risk of AF and stroke is the focus of the present review paper.

KW - atrial fibrillation

KW - left atrial appendage

KW - left atrium

KW - multimodality imaging

KW - stroke

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Structure and Function of the Left Atrium and Left Atrial Appendage: AF and Stroke Implications

Abstract

Keywords

ASJC Scopus subject areas

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