title: Left Atrial Reverse Remodeling: Mechanisms, Evaluation, and Clinical Significance.
abstract: 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.
authors.affiliation: Westmead Hospital, Westmead Clinical School at University of Sydney and South West Sydney Clinical School at University of NSW, Sydney, Australia. Electronic address: l.thomas@unsw.edu.au.
authors.forename: Liza
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Canberra Hospital, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
authors.forename: Walter P
authors.initials: WP
authors.lastname: Abhayaratna
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D057791:Cardiac Imaging Techniques; D005355:Fibrosis; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012307:Risk Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016277:Ventricular Function, Left
keywords: functional remodeling; left atrium; reverse remodeling; structural remodeling