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atrial failure; atrial insufficiency; atrial dysfunction; atrial myopathy; atrial cardiopathy
Etiology:
- cardiac conduction system disorders affecting atrial & interatrial contraction
- interatrial block
- left ventricular diastolic dysfunction (HFpEF) ?
Pathology:
- progressive fibrosis of atrial wall
- neurohormonal alterations perpetuate atrial failure
Laboratory:
- serum N-terminal pro-BNP > 250 pg/mL [3]
Special laboratory:
- electrocardiogram: p-wave analysis: lead V1 P-wave terminal force > uV/msec
- echocardiogram: left atrial enlargement: left atrial diameter index >= 3 cm/m2 [3]
Complications:
- increased risk for dementia [2]
Management:
- treat left ventricular diastolic dysfunction (HFpEF) is proposed
- if atrial fibrillation apixaban
- if not, apixaban & 81 mg aspirin equivalent in preventing cryptogenic stroke [3]
Related
atrial fibrillation (AF)
General
heart failure (HF)
References
- Lowry MA
Atrial Failure or Insufficiency: A New Syndrome.
Medscape. Jan 13, 2023
https://www.medscape.com/viewarticle/986950
- Bisbal F et al
Atrial Failure as a Clinical Entity: JACC Review Topic of the Week.
J Am Coll Cardiol 2020. 75(2):222-232
Medscape. March 27, 2022
PMID: 31948652 Free article
https://www.sciencedirect.com/science/article/pii/S0735109719384530
- Hughes S
Left Atrial Dysfunction Linked to Future Dementia Risk.
https://www.medscape.com/viewarticle/970991
- Wang W, Zhang MJ, Inciardi RM et al
Association of Echocardiographic Measures of Left Atrial Function and Size With
Incident Dementia.
JAMA. 2022;327(12):1138-1148.
https://jamanetwork.com/journals/jama/fullarticle/2790285
- Kamel H et al.
Apixaban to prevent recurrence after cryptogenic stroke in patients with
atrial cardiopathy: The ARCADIA randomized clinical trial.
JAMA 2024 Feb 20; 331:573.
PMID: 38324415 PMCID: PMC10851142 (available on 2024-08-07)
https://jamanetwork.com/journals/jama/fullarticle/2814933