Role of the left atrium

There is currently a general consensus in the literature about the definitions of diastolic dysfunction and diastolic failure, even though these concepts have only relatively recently been introduced into the clinical arena. The key to their definitions, as discussed in other chapters, is the central and predominant role played by the ventricular chamber in terms of its ability to accommodate adequate filling volume at reasonably low pressure through its capacity to rapidly relax while maintaining chamber elastic properties.1 More marginal, if not completely neglected, is the role of the atrial chamber within the clinical scenario of diastolic dysfunction and failure. Recently, however, several studies have demonstrated how the left atrium plays a primary role not only in modulating ventricular filling and function through the atrioventricular interaction mechanism but also in providing important prognostic clues for the risk stratification of patients with diastolic dysfunction.2,3