How To: Measure Left Atrial Volumes
Step by Step Guide
Left atrial volume index (LAVI) is a key marker of chronic diastolic dysfunction, reflecting increased left ventricular filling pressures. Accurate measurement and reporting are essential, as LAVI directly influences our process to grade and monitor diastolic dysfunction. Finding high quality imaging windows and following this guide are sure to improve your left atrial volume assessment.
Step 1: Acquire an on-axis apical 4-chamber view.
Step 2: Zoom on the left atrium and freeze the image at ventricular end-systole—this is when the left atrium appears largest (typically one frame before mitral valve opening).
Step 3: Trace the left atrial endocardial border, being careful to exclude the pulmonary veins and left atrial appendage (if visible).
Step 4: Measure the left atrial end-systolic length, from the center of the mitral annular plane to the roof of the atrium.
Step 5: Repeat Steps 1–4 in an on-axis apical 2-chamber view.
Pro Tip: The left atrial length measurements in the apical 4 and apical 2 chamber views should differ by less than 5 mm. Greater discrepancies may indicate foreshortening or an off-axis view.
Practice Tests
Boost your echo exam prep with targeted practice questions and mock exams—complete with detailed explanations and a mobile-friendly design.
We focus on what really matters for mastering the art of echo, unlike the big companies that often miss the mark.
You Might Also Like…
