How should we measure left atrium size and function?

Echocardiographic assessment of left atrial size from M-mode or 2D echocardiography measurements has been used in clinical and research studies for years, but its accuracy is now questioned. New techniques, such as 3D and tissue Doppler imaging, assessing velocities, strain and strain rate, provide improved prognostic value in a wide range of diseases. 2D strain imaging using speckle tracking on B-mode images may yield even better, angle-independent, results than tissue Doppler imaging-derived strain echocardiography. Finally, velocity vector imaging is a novel image analysis technique that may be used to quantify left atrial volume.