A Review published in Crit_Care presents an overview of left atrial physiology, including invasive and non-invasive methods of left atrial pressure measurement and their potential clinical application.
]. A simplified 4-sector method described by Mayr et al. only just underperformed against the more laborious 28-sector method, and a cut off value of ≥ 15 B lines resulted in a sensitivity of 91.7% and specificity of 92.1% to identify patients with increased extravascular lung water [].
The combined strength of invasive and advanced echo techniques offers a pathway to evaluate both ends of the circuit, from LA function and pressure to pulmonary haemodynamics and RV function. Perhaps, this amalgamation can enable a more comprehensive understanding of ‘transpulmonary circuit dysfunction’ and its consequence to cardiac performance at the bedside, where it really matters.
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