Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

As specialized compartments of the heart, the atria feature unique mechanical and structural properties that differ considerably from those of the ventricular myocardium. Beyond their contribution to cardiac output as a reservoir, conduit, and booster pump at different phases of the cardiac cycle, the atria determine heart rhythm, regularity, and rate (chronotropy). They also function as mechanical sensors and exert relevant endocrine activity (e.g. natriuretic peptides). Atrial remodelling is often observed in association with ventricular remodelling in heart failure (HF) but by itself adds to the complexity of the disease.