Chambers

Left atrium

An important statement that should not be missing in any echocardio-report is the dimension of the LA. Many diseases are related to the LA, like arrhythmias, systolic and diastolic heart failure, mitral valve disorders. The LA has an increasingly important role in echocardiography which can be seen from the measurements in time: first there was the M-mode measurement in PLAX and later on in 2D, then there was the length and width measurement in the AP4CH view. But nowerdays LA volume index (LAVI) is the standard, and there is even the ability to produce LA volume in 3D.

 

LA dimensions

Parameter Women Men            
  Normal Mildly
abnormal		 Moderately
abnormal		 Severely
abnormal		 Normal Mildly
abnormal		 Moderately
abnormal		 Severely
abnormal
LA diameter, cm 2.7–3.8 3.9–4.2 4.3–4.6 ≥4.7 3.0–4.0 4.1–4.6 4.7–5.2 ≥5.2
LA diameter/BSA, cm/m² 1.5–2.3 2.4–2.6 2.7–2.9 ≥3.0 1.5–2.3 2.4–2.6 2.7–2.9 ≥3.0
LA minor-axis dimension, cm 2.9–4.5 4.6–4.9 5.0–5.4 ≥5.5 2.9–4.5 4.6–4.9 5.0–5.4 ≥5.5
LA minor-axis dimension/BSA, cm/m² 1.7–2.5 2.6–2.8 2.9–3.1 ≥3.2 1.7–2.5 2.6–2.8 2.9–3.1 ≥3.2
LA area, cm² ≤20 20–30 30–40 >40 ≤20 20–30 30–40 >40
LA volume, mL 22–52 53–62 63–72 ≥73 18–58 59–68 69–78 ≥79

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LA function

Left atrial functions and stiffness according to age; results from the NORRE study (2018)
Parameter Age 20 -40 Age 41 -60 Age >60
  Medial (IQR) Medial (IQR) Medial (IQR)
Reservoir function
LA strain (%) 46,8 (42,3-52,4) 40,9 (35,4-46,1) 35,5 (30,9-41,9)
2D LAEF (%) 71,3 (67,3-74,9) 66,7(62,8-72,4) 64,0 (58,1-69,5)
3D LAEF (%) 58,4 (53,1-63,1) 57,1 (52,2-61,3) 55,6 (50,6-60,4)
Conduit function
LA passive strain (%) 30,6 (26,8-36,5) 24,1 (19,7-29,3) 18,6 (14,7-22,6)
Pump function
LA active strain (%) 15,6 (11,9-19,0) 16,3 (13,2-19,6) 16,8 (13,6-21,4)
Stiffness
E/é 5,6 (4,8-6,7) 6,8 (5,8-8,3) 8,3 (7,1-9,8)
E/é / LA strain 0,12 (0,10-0,15) 0,16 (0,13-0,22) 0,24 (0,18-0,29)
E/é / 2D LVEF 0,08 (0,07-0,09) 0,10 (0,09-0,12) 0,14 (0,11-0,15)
E/é / 3D LVEF 0,10 (0,08-0,12) 0,11 (0,10-0,15) 0,15 (0,13-0,17)

 

LA strain component Mean 95% CI Cochrane Q I2 Ƭ2
Reservoir (%) 39.4 38.0–40.8 1,653 (P < .001) 97.6 20.0
Conduit (%) 23.0 20.7–25.2 420 (P < .001) 96.9 17.9
Contractile (%) 17.4 16.0–19.0 631 (P < .001) 97.3 9.7

The information above comes from Echocardiografie.nl. Last changed on: 4 September 2023.