Until recently the LA had been subordinated to the LV, but cardiologists now recognize that LA function is indispensable to normal circulatory performance, conditioning the morbidity and mortality in several diseases. This is partly due to the enormous attention given to the evaluation of the left ventricle (LV), a lack of familiarity with ultrasound techniques that can be used in imaging the LA, and the absence of validation of a unique standardized technique to investigate LA deformation.
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The systematic assessment of LA function is not uniformly carried out.
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IntroductionĬlinical evaluation of the left atrium (LA) is important in many cardiac and noncardiac diseases, requiring an in-depth understanding of anatomy and physiology. LA dysfunction and its important prognostic implications may be detected sooner by LA strain than by volumetric measurements. Now, together with conventional echocardiographic parameters, new echocardiographic techniques, such as strain Doppler, 2D speckle tracking and three-dimensional (3D) echocardiography, allow assessing early LA dysfunction and they all play a fundamental role to detect early functional remodelling before anatomical alterations occur. Echocardiographers initially focused on early detection of atrial geometrical abnormalities through monodimensional atrial diameter quantification and then bidimensional (2D) areas and volume estimation. Although often referred to as “the forgotten chamber”, compared with left ventricle (LV), especially in the past years, the left atrium (LA) plays a critical role in the clinical expression and prognosis of patients with heart and cerebrovascular disease, as demonstrated by several studies.