Evaluation of Left Atrial Size and Function: Relevance for Clinical Practice

•The LA is emerging as a biomarker for evaluation of diastolic dysfunction, AF, and HFpEF. •LA size, although routinely evaluated by 2DE, may be more accurately evaluated by 3DE. •LA function is important and may demonstrate alterations prior to changes in LA volume. •Both volumetric and strain analysis can be performed to evaluate LA phasic function. •Noninvasive evaluation of LA pressure is emerging as an important modality. Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions. Moreover, noninvasive evaluation of LA pressure has gained importance in the characterization of the hemodynamic profile of patients. This review describes the methodology, benefits and pitfalls of measuring LA size and function by echocardiography and provides a brief overview of the prognostic utility of newer echocardiographic metrics of LA geometry and function (i.e., three-dimensional volumes, longitudinal strain, and phasic function parameters). Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions. Moreover, noninvasive evaluation of LA pressure has gained importance in the characterization of the hemodynamic profile of patients. This review describes the methodology, benefits and pitfalls of measuring LA size and function by echocardiography and provides a brief overview of the prognostic utility of newer echocardiographic metrics of LA geometry and function (i.e., three-dimensional volumes, longitudinal strain, and phasic function parameters).