Background: The left atrium modulate left ventricular filling and plays a role in maintaining overall cardiac function during left ventricular ischemia by reactive hyperactivity, Cardiovascular disease is recognized as the leading cause of death in RA patients. Methods and Findings: 30 healthy control, & 45 RA patient subjected to full clinical assessment, DAS 28 ESR score, full laboratory evaluation, conventional and tissue Doppler imaging (TDI) and strain (S) and strain rate (SR) analysis by two-dimensional speckle tracking of the left atrium. We found statistically significant difference in 2 Left atrial PEF, 2 Left atrial EI, 2 Left atrial TEF, TDI mitral lateral annulus e’, TDI mitral lateral annulus S, Average SR E 1/s between patients and controls,& negative correlation between TDI lateral e, TDI lateral s, and Strain rate e and rheumatoid factor, There was negative correlation between 2LA PEF, 2LA EI, and 2LA TEF . Rheumatoid factor is correlated to strain rate e, and negatively correlated with left atrial passive emptying. Conclusion: RA had alteration in left LV longitudinal myocardial function, left atrial expansion volume can be a predictor of AF in RA. RA patient had more left atrial stiffness. Our study concluded cardiac affection is more in seropositive RA patients.