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Left atrial phasic function: physiology, clinical assessment and prognostic value
  1. Aaisha Ferkh1,2,
  2. Amy Clark1,2,
  3. Liza Thomas1,2
  1. 1Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia
  2. 2Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Professor Liza Thomas, Cardiology, Westmead Hospital, Westmead, NSW 2145, Australia; liza.thomas{at}


Left atrial (LA) phasic function provides significant insights into the pathophysiology of cardiovascular disease. LA function is described in three phases: reservoir (atrial filling, during systole), conduit (passive emptying, during early diastole) and contractile (active emptying, during late diastole). LA phasic function can be evaluated by different imaging modalities, and a variety of techniques including volumetric analysis, deformation (strain) and Doppler methods. LA phasic function (particularly LA reservoir strain) is more sensitive and provides earlier detection of LA dysfunction than alterations in LA volume. LA function parameters have also demonstrated significant diagnostic and prognostic value, particularly in heart failure, atrial fibrillation and stroke. However, there remain barriers to implementation of phasic function parameters in clinical practice and guidelines. This review outlines the physiology of LA phasic function, methods of assessment, and its diagnostic and prognostic utility in varying pathologies.

  • atrial fibrillation
  • cardiac imaging techniques
  • echocardiography
  • diagnostic imaging
  • heart failure, diastolic

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  • Contributors LT, AF and AC designed the study. AF was primarily responsible for the abstract, introduction and conclusion, physiology and clinical utility sections. AC was primarily responsible for the clinical assessment section. AF and AC were supervised by LT. All authors contributed to all sections, reviewed and edited the entire manuscript, and agree with the content of the article.

  • Funding AF was supported by the University of Sydney Faculty of Medicine and Health Executive Dean Stipend Scholarship.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.