# Left Atrial Volume Index (LAVI)

Determines the left atrial size indexed to body surface area to help diagnose abnormal dilatation.

Refer to the text below the tool for more information about the LAVI formula and result interpretation.

Left Atrial Volume Index (LAVI) has been found to correlate with mortality from cardiovascular disease and may be measured at the end-ventricular systole, when the Left Atrial is at its maxim size.

Gender differences are then accounted for by indexing the volume to body surface area (BSA) via the Mosteller equation.

• `LA Volume = (8 /3 π) x (A1 x A2 / L) = 0.85 x (A1 x A2 / L)`
• `LAVI = LA Volume / BSA`
 LAVI (mL/m2) Interpretation < 16 Below normal range 16 - 35 Normal range 35 - 42 Mildly abnormal 42 - 48 Moderately abnormal ≥ 48 Severely abnormal

Max. planimetered LA area in apical 4-chamber (A1)
Max. planimetered LA area in apical 4-chamber (A2)
Length measured from back wall to line across mitral valve hinge points (L)
Do you know the Body Surface Area (BSA)?
Body Surface Area (BSA)
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Steps on how to print your input & results:

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

## Left Atrial Volume Index Explained

Left Atrial Volume Index (LAVI) has been found to correlate with mortality from cardiovascular disease and may be measured at the end-ventricular systole, when the LA is at its maxim size. Gender differences are then accounted for by indexing the volume to body surface area (BSA) via the Mosteller equation.

• `LA Volume = (8 /3 π) x (A1 x A2 / L) = 0.85 x (A1 x A2 / L)`
• `LAVI = LA Volume / BSA`

Where:

• A1 = planimetered LA area in apical 4-chamber (A4C) view;
• A2 = Max. planimetered LA area in apical 2-chamber (A2C) view;
• L = the LA long-axis length determined as the distance of the perpendicular line measured from the middle of the plane of the mitral annulus to the superior aspect of the LA.

The increases from the normal left atrial volume index may be interpreted as follows:

 LAVI (mL/m2) Interpretation < 16 Below normal range 16 - 35 Normal range 35 - 42 Mildly abnormal 42 - 48 Moderately abnormal ≥ 48 Severely abnormal

Left Atrial Volume Index was found to predict mortality risk, independent of LV geometry in a large cohort of patients with preserved systolic function.

Abnormal LV geometry and mortality were significantly higher in patients with increased LAVI, who had a 42% increased risk of mortality (those with severe LAVI).

In patients with normal LV geometry or concentric remodeling, a severe LAVI carried an increased mortality risk of 28% and 46%, respectively.

Increased LAVI was also found to be a powerful predictor of mortality after acute myocardial infarction (AMI), where Doppler variables are affected by multiple factors and may change rapidly, since LAVI is less influenced by acute changes and reflects subacute or chronic diastolic function.

## References

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):1-39.

Lester SJ, et al. Best method in clinical practice and in research studies to determine left atrial size. Am J Cardiol 1999; 84:829-32.

Pritchett AM, Redfield MM, et al. Left atrial volume as an index of left atrial size: a population-based study. J Am Coll Cardiol 2003; 41:1036-43.

Patel DA, Lavie CJ, Milani RV, Ventura HO. Left atrial volume index predictive of mortality independent of left ventricular geometry in a large clinical cohort with preserved ejection fraction. Mayo Clin Proc. 2011; 86(8):730-7.

Moller JE, Hillis GS, Oh JK, et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003; 107(17):2207-2212.

Specialty: Cardiology

System: Cardiovascular

Abbreviation: LAVI

Article By: Denise Nedea

Published On: July 15, 2020 · 12:00 AM

Last Checked: July 15, 2020

Next Review: July 15, 2025