Global left atrial failure in heart failure.
The left atrium plays an important role in the maintenance of cardiovascular and neurohumoral homeostasis in heart failure. However, with progressive left ventricular dysfunction, left atrial (LA) dilation and mechanical failure develop, which frequently culminate in atrial fibrillation. Moreover, LA mechanical failure is accompanied by LA endocrine failure [deficient atrial natriuretic peptide (ANP) processing-synthesis/development of ANP resistance) and LA regulatory failure (dominance of sympathetic nervous system excitatory mechanisms, excessive vasopressin release) contributing to neurohumoral overactivity, vasoconstriction, and volume overload (global LA failure). The purpose of the present review is to describe the characteristics and emphasize the clinical significance of global LA failure in patients with heart failure.
Department of Cardiology, Larissa University Hospital, PO Box 1425, 411 10, Larissa, Greece. ftriposkiadis@gmail.com.
Filippos
F
Triposkiadis
Department of Internal Medicine and Cardiology, Charité University Medicine Berlin-Campus Virchow Klinikum, and Department of Internal Medicine and Cardiology, German Heart Centre, Berlin Centre for Heart Failure, Berlin, Germany.
Burkert
B
Pieske
Cardiology Division, School of Medicine, Stony Brook University, Stony Brook, NY, USA.
Javed
J
Butler
Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.
John
J
Parissis
Department of Cardiology, Larissa University Hospital, PO Box 1425, 411 10, Larissa, Greece.
Gregory
G
Giamouzis
Department of Cardiology, Larissa University Hospital, PO Box 1425, 411 10, Larissa, Greece.
John
J
Skoularigis
Laboratory of Physiopharmacology (Building T2), University of Antwerp, Universiteitsplein 1, Antwerp, 2610, Belgium.
Dirk
D
Brutsaert
Ohio State University, Columbus, Ohio, USA.|Biomedical Research Foundation Academy of Athens, Athens, and Aristotelian University of Thessaloniki, Thessaloniki, Greece.
Harisios
H
Boudoulas
D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology*; D016279:Atrial Function, Left; D009320:Atrial Natriuretic Factor / Q000378:metabolism; D006325:Heart Atria / Q000378:metabolism / Q000503:physiopathology*; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014661:Vasoconstriction; D014667:Vasopressins / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*
D014667:Vasopressins; D009320:Atrial Natriuretic Factor
Dilatation; Heart failure; Left atrium; Natriuretic peptide