Muristek
Echocardiographic Measures of Left Atrial Function and Size and Incident Dementia
To the Editor A recent study described a significant association between left atrial function and an increased risk of subsequent dementia, independent of the presence of atrial fibrillation. These findings are similar to our 2009 study, which examined subclinical left atrial dysfunction and risk of stroke in patients with patent foramen ovale (PFO). We found that impairment of reservoir, conduit, and contractile strain and impairment of emptying, passive emptying, and active emptying fraction was present in patients with multiple ischemic events, PFO, and atrial septal aneurysm compared with healthy individuals. After PFO device-based closure, we observed a normalization of these echocardiographic parameters. A more recent study performed by our group confirmed this finding in patients with PFO using computational fluid dynamic simulation. Therefore, we are concerned that the study by Ms Wang and colleagues did not evaluate the presence of interatrial septal defects. In addition, we believe that infiltrative, inflammatory, and endocrine diseases and toxic causes such as alcohol and chemotherapeutic agents that may predispose to atrial cardiomyopathy should have been reported in this study. It would also be of interest to determine whether the left atrium may represent an earlier site of deposition of amyloid-β peptide, in which case assessment of left atrial impairment could be an early indirect marker of Alzheimer disease.
Most Read