Left atrial anatomy and physiology: echo/Doppler assessment.

PURPOSE OF REVIEW: This article provides a state-of-the-art perspective of left atrial anatomy and physiology.

RECENT FINDINGS: Left atrial structure and function can be used to reflect and quantify the physiologic state of complex disease processes. No single left atrial anatomic, functional, or clinical feature will adequately define a complex system. The state of combined left atrial structural and functional features (i.e., systems biology) defines disease clustering (i.e., commonality of underlying left atrial pathophysiology), cause and effect (i.e., left atrial dynamics impute disease events as consequences), disease classification (e.g., primary vs. secondary atrial fibrillation), and intensity of a pathophysiologic state (i.e., quantifiably infer the magnitude of a pathophysiologic perturbation), and helps explain complex pathophysiology (e.g., myocyte death vs. hibernation).

SUMMARY: Individual left atrial structural and functional features do not define the state of complex systems. Systems biology and multifeature profiles of left atrial anatomy and physiology should be used to assist the prediction, management, and, ultimately, prevention of preclinical and overt complex disease processes.