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

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. (Am Heart J 2008;156:1056-64.)