The Interplay Between Dementia, Atrial Arrhythmias, and Atrial Cardiomyopathies: The Role of Cardiac Imaging and Left Atrial Assessment.

Atrial fibrillation (AF) and atrial cardiomyopathies are strongly linked to cognitive decline, even in the absence of stroke. This article explores the mechanisms underlying this association, emphasizing the role of advanced cardiac imaging-particularly left atrial (LA) assessment. Structural and functional atrial remodeling may contribute to both arrhythmogenesis and impaired cerebral perfusion, fostering neurodegeneration. Novel echocardiographic techniques such as strain imaging provide valuable insights into atrial dysfunction, potentially aiding in early detection and risk stratification for dementia. Routine LA evaluation in AF and atrial myopathy patients may improve clinical outcomes by guiding tailored therapeutic strategies.