Echocardiographic evaluation of left atrial size and function: Current understanding, pathophysiologic correlates, and prognostic implications

• Published in: The American heart journal Vol. 156; no. 6; pp. 1056 - 1064
• Main Authors: Leung, Dominic Y., MBBS, FRCP, FHKCP, FRACP, FACC, PhD, Boyd, Anita, B Med Sc Hons, Ng, Arnold A., BSc(Med), MBBS, FRACP, DDU, Chi, Cecilia, Thomas, Liza, MBBS, FRACP, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.12.2008; Mosby; Elsevier Limited
• Subjects: Age Factors; Agreements; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - mortality; Atrial Fibrillation - physiopathology; Atrial Function, Left - physiology; Biological and medical sciences; Blood Flow Velocity - physiology; Cardiac arrhythmia; Cardiac Volume - physiology; Cardiology. Vascular system; Cardiomegaly - diagnostic imaging; Cardiomegaly - mortality; Cardiomegaly - physiopathology; Cardiovascular; Cardiovascular system; Coronary Disease - diagnostic imaging; Coronary Disease - mortality; Coronary Disease - physiopathology; Echocardiography; Echocardiography, Doppler, Color; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Failure - diagnostic imaging; Heart Failure - mortality; Heart Failure - physiopathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical imaging; Medical sciences; Methods; Myocardial Contraction; NMR; Nuclear magnetic resonance; Prognosis; Strain rate; Stroke; Stroke - diagnostic imaging; Stroke - mortality; Stroke - physiopathology; Studies; Survival Analysis; Ultrasonic investigative techniques; Veins & arteries; Sonography; Evaluation; Echocardiography; Prognosis; Size; Cardiovascular disease; Circulatory system; Left atrium; Cardiology; Current
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2008.07.021

Left atrial (LA) volume has recently been identified as a potential biomarker for cardiac and cerebrovascular disease. However, evidence regarding the prognostic implications of LA volume still remains unclear. Evaluation of LA size and function using traditional and more recent echocardiographic parameters is potentially feasible in the routine clinical setting. This review article discusses the conventional and newer echocardiographic parameters used to evaluate LA size and function. Conventional parameters include the assessment of phasic atrial activity using atrial volume measurements, transmitral Doppler peak A velocity, atrial fraction, and the atrial ejection force. Newer parameters include Doppler tissue imaging (DTI) including segmental atrial function assessment using color DTI, strain, and strain rate. In addition, an overview of the implications and clinical relevance of the findings of an enlarged left atrium, from currently available literature, is presented.