What Is the Best Approach for the Assessment of Left Atrial Size? Comparison of Various Unidimensional and Two-dimensional Parameters with Three-dimensional Echocardiographically Determined Left Atrial Volume

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

“…[311][312][313][314][315][316] In the absence of MVD, an increase in LA size most commonly reflects increased wall tension as a result of increased LA pressure, [317][318][319][320] as well as impairment in LA function secondary to atrial myopathy. 321,322 A clear relationship exists between an enlarged LA and the incidence of atrial fibrillation and stroke, [323][324][325][326][327][328][329][330][331][332] risk for overall mortality after myocardial infarction, 321,322,333,334 risk for death and hospitalization in patients with dilated cardiomyopathy, [335][336][337][338][339][340][341][342][343][344] and major cardiac events or death in patients with diabetes mellitus. 345 left atrium enlargement is a marker of both the severity and chronicity of diastolic dysfunction and magnitude of LA pressure elevation.…”

Complexities of Left Atrial Analysis

“…In fact, there is data to suggest that left atrial enlargement in the antero-posterior direction is constricted by the presence of the spine and sternum, and accordingly, most of the LA enlargement tends to occur in the superior-inferior direction. 4 Because of this, the use of m-mode echocardiography was strongly discouraged in the American Society of Echocardiography 2005 chamber quantification guidelines, and measurements of LA volumes were recommended for clinical practice. 5 Both the 2005 and the current 2015 chamber quantification guidelines recommend the use of the biplane method of discs or the area-length method for the measurement of LA volumes.…”

Prognostic implications of left atrial dilation evaluated by echocardiographic volume in patients with normal left atrial antero-posterior dimensions

“…Prognostic implications of LA dilation evaluated by LAV in patients with normal LAD LAV measured by echocardiography is an important predictor of cardiovascular events [1] and is a more sensitive predictor than LAD of cardiovascular events in patients with sinus rhythm [3]. Prognostic implications of LA dilation, defined as a normal LAD but an abnormal LAV, however, have not been determined.…”

“…Left atrial (LA) size measured by echocardiography is an important predictor of cardiovascular events [1][2][3]. LA size historically has been measured using antero-posterior dimensions (LAD) by M-mode echocardiography.…”

“…LA size historically has been measured using antero-posterior dimensions (LAD) by M-mode echocardiography. Since recently, LA volume (LAV) can be precisely determined by two-dimensional echocardiography and has been suggested to be a more accurate index of LA size and a better predictor of cardiac events than LAD [3,4]. However, echocardiographic measurement of LAV has not been widely performed because of technical difficulties, and several echocardiographic laboratories continue to use LAD because it is easier to measure.…”