Comprehensive echocardiographic assessment of the left atrium in daily practice: a practical guide

The left atrium (LA) is a crucial component of cardiovascular performance. A thorough understanding of LA anatomy, physiology, and pathology is necessary for diagnostic and prognostic purposes in daily clinical practice. LA volume is widely recognized as a novel biomarker for cardiovascular risks in the general population. Furthermore, it has been shown to be a significant prognostic factor in various cardiac conditions, such as atrial fibrillation, ischemic heart disease, valvular heart disease, and heart failure. The assessment of LA function in physiologic and pathologic states has gathered interest with expanding research supporting its utility as a biomarker for outcomes in different cardiovascular abnormalities. Utilizing basic and advanced echocardiographic modalities and integrating multiple parameters helps in both qualitative and quantitative assessment of LA size and function. This is a narrative review provides a comprehensive approach to assessing LA size and function by interpreting existing English-language literature, including landmark studies, reviews and consensus documents from leading echocardiography societies. The literature search focused on key terms, such as LA size, phasic function, strain, and Doppler hemodynamics. By collecting, analyzing, and grouping the echocardiographic parameters, we introduce a simplified approach to guide clinicians through a comprehensive LA assessment ranging from standard 2D dimensions to advanced deformational tracking tailored to specific clinical indications.