European Journal of Echocardiography (2011) 12, 421–430 doi:10.1093/ejechocard/jeq175

REVIEW

Left atrial function: physiology, assessment, and clinical implications
Gustavo G. Blume 1, Christopher J. Mcleod 1, Marion E. Barnes 2, James B. Seward 1, Patricia A. Pellikka 1, Paul M. Bastiansen 1, and Teresa S.M. Tsang 2*
1 Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA; and 2Division of Cardiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada

Online publish-ahead-of-print 12 May 2011

The interest in the left atrium (LA) has resurged over the recent years. In the early 1980s, multiple studies were conducted to determine the normal values of LA size. Over the past decade, LA size as an imaging biomarker has been consistently shown to be a powerful predictor of outcomes, including major public health problems such as atrial fibrillation, heart failure, stroke, and death. More recently, functional assessment of the LA has been shown to be, at least as, if not more robust, a marker of cardiovascular outcomes. Current available data suggest that the combined evaluation of LA size and LA function will augment prognostication. The aim of this review is to provide a critical appraisal of current echocardiographic techniques for the assessment of LA function and the implications of such assessment for prediction and disease prevention.

----------------------------------------------------------------------------------------------------------------------------------------------------------Keywords
Left atrium † Left atrial function † Echocardiography

Introduction
The left atrium (LA) is far from being a simple passive transport chamber. It is highly dynamic and responds to stretch with the secretion of atrial natriuretic peptides. The counterbalance of natriuresis, vasodilatation, and