Essayagh B, Antoine C, Benfari G, et al. - Using a cohort of 5,769 (63 ± 16 years, 47% women) consecutive patients with degenerative mitral valve disease, researchers if left atrial volume index (LAVI) assessed in routine clinical practice of multiple sonographers/cardiologists and degenerative mitral regurgitation (DMR) survival were independently linked. Prospective measurements of LAVI were obtained. A wide distribution of LAVI (43 ± 24 ml/m2) was reported: < 40 ml/m2 in 3,154 patients, 40 to 59 ml/m2 in 1,606, and ≥ 60 ml/m2 in 1,009. Overall and in all subsets, a robust, incremental, and independent link between frequent left atrial enlargement of DMR (as measured by LAVI in routine practice) with excess mortality was evident, which was in part improved by mitral surgery. The inclusion of LAVI measurement as a component of routine DMR assessment and the clinical decision-making process was recommended.