A resurgence of interest in atrial function has enhanced our understanding of the atrial contributions to cardiovascular performance in health and disease. Despite this attention, quantifying atrial function is difficult, in part because the atria are geometrically complex and because of the critical interplay between the cardiac cycle-dependent atrial functions and ventricular performance. The primary mechanical function of the left atrium (LA) is to modulate left ventricular filling and cardiovascular performance, a task that is accomplished by its interrelated atrial roles as a reservoir for pulmonary venous flow during ventricular systole, as a conduit for pulmonary venous flow during early ventricular diastole, and as a booster pump that increases ventricular filling during late ventricular diastole. This chapter will discuss these cycle-dependent functions in the context of normal LA physiology, ventricular systolic and diastolic dysfunction, and primary atrial myocardial disease using the LA pressure-volume relation, conventional methods, and deformation analysis.
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