EDITORIAL Function over form? Assessing the left atrium in heart failure

This editorial refers to ‘Left atrial function measured by cardiac magnetic resonance imaging in patients with heart failure: clinical associations and prognostic value’, by P. Pellicori et al. on page doi:10.1093/eurheartj/ehu405 The understanding of heart failure (HF) haemodynamics has trad-itionally focused on left ventricular (LV) structure and function, with the left atrium being viewed simply as a passive transport chamber that empties into the left ventricle. Over the last decade, there has been increasing recognition of the importance of left atrial (LA) structure and function in the pathophysiology of HF. LA volume was first to be established as a biomarker integrating the mag-nitudeand duration of LVdiastolic function, and a predictorof cardio-vascular outcomes in HF. More recently, LA function has emerged as a novel determinant of clinical status and outcomes in HF, and perhaps an even more robust prognostic marker than LA volum