Echo Reference — Chamber Quantification
Left Atrial Size & Function
Left atrial volume, indexed volume (LAVI), and reservoir strain (LASr) reference values with severity grading. Normal values by sex from the WASE study.
Normal Left Atrial Size & Function
Left atrial volume should be measured using the biplane method of discs (Simpson's) from apical four-chamber and two-chamber views at end-systole (just before mitral valve opening). LAVI is calculated by dividing LAV by BSA.
| Parameter | Men | Women |
|---|---|---|
| LAV (mL) | 48.0 ± 16.8 | 43.6 ± 14.1 |
| LAVI (mL/m²) | 25.2 ± 7.9 | 26.3 ± 8.0 |
| LASr (%) | 42.0 ± 9.9 | 42.3 ± 10.1 |
LA reservoir strain: LASr < 18% is associated with elevated filling pressures and should prompt further diastolic function assessment.
LAVI — Severity Grading
Sex-independent grading of indexed left atrial volume. These thresholds apply to both men and women.
| LAVI (mL/m²) | Normal | Mildly Abnormal | Moderately Abnormal | Severely Abnormal |
|---|---|---|---|---|
| Threshold | < 34 | 34 – 41 | 42 – 48 | > 48 |
Clinical context: LAVI > 34 mL/m² is one of the key variables in the 2025 ASE diastolic function grading algorithm. An elevated LAVI in the setting of reduced e' and increased E/e' supports elevated filling pressures. LAVI is also a strong independent predictor of adverse cardiovascular outcomes including atrial fibrillation, stroke, heart failure, and mortality.
LAVI Calculator
Enter left atrial volume (biplane method of discs) and BSA, or height and weight to auto-calculate BSA. Returns indexed LA volume and severity grade.
BSA
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LA Volume
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LAVI
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References
- Singh A, et al; WASE Investigators. Normal Values of Left Atrial Size and Function and the Impact of Age: Results of the World Alliance Societies of Echocardiography Study. J Am Soc Echocardiogr. 2022;35(2):154–164.e3.
- Fung A, et al. Left Atrial Volume Index by Echocardiography — Improved, Objective, and Simplified Cutoff Values for Abnormality Based on Association With Survival. Heart, Lung and Circulation. 2022;33:S200–S201.
- Lang RM, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.
- Nagueh SF, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography and for Heart Failure With Preserved Ejection Fraction Diagnosis: An Update From the American Society of Echocardiography. J Am Soc Echocardiogr. 2025;38(7):537–569.