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Effects of age on left atrial volume and strain parameters using echocardiography in a normal black population
Echo Research & Practice volume 3, pages 115–123 (2016)
Abstract
Objective: Normal cut-off values for left atrial (LA) size and function may be altered by aging and ethnic differences. No age-related reference values for LA volumetric measurements or LA strain exist in Africans. We aimed to establish normal age-appropriate values of LA size and function in black Africans. Additionally, we studied the correlation between age, LA strain and volumetric parameters.
Methods: In this prospective, cross-sectional study of 120 individuals (mean age 38.7±12.8 years, 50% men), subjects were classified into four age groups: 18-29, 30-39, 40-49 and 50-70 years. LA volumes were measured by biplane Simpson’s method, and Philips QLAB 9 (Amsterdam, The Netherlands) speckle-tracking software was used to measure LA peak strain in the reservoir (ƐR) and contractile phase (ƐCT).
Results: No significant differences in the maximum and minimum LAVi were noted among the four age categories (P=0.1, P=0.2). LA volumetric function assessment showed no difference in reservoir function between age groups (P<0.05), conduit function decreased with advancing age (r=−0.3, P<0.001) and booster function displayed a significant increase with age (LA active emptying volume index, P=0.001). There was a significant decrease in LA ƐR (P<0.0001) in the older age groups, whereas ƐCT remained unchanged (P=0.27).p ]Conclusion: Age-related changes in LA reservoir, conduit and contractile function in black Africans are similar to those observed in other populations, as was the trend of declining ƐR with advancing age. The preservation of ƐCT with increasing age requires further analysis.
References
D’Andrea A, Riegler L, Rucco MA, Cocchia R, Scarafile R, Salerno G, Martone F, Vriz O, Caso P, Calabrò R et al 2013 Left atrial volume index in healthy subjects: clinical and echocardiographic correlates. Echocardiography 30 1001–1007. (doi:10.1111/echo.12217)
Nikitin NP, Witte KK, Thackray SD, Goodge LJ, Clark AL, Cleland JG 2003 Effect of age and sex on left atrial morphology and function. European Journal of Echocardiography 4 36–42. (doi:10.1053/euje.4.1.36)
Vieira MJ, Teixeira R, Gonçalves L, Gersh BJ 2014 Left atrial mechanics: echocardiographic assessment and clinical implications. Journal of the American Society of Echocardiography 27 463–478. (doi:10.1016/j.echo.2014.01.021)
Cameli M, Lisi M, Righini FM, Mondillo S 2012 Novel echocardiographic techniques to assess left atrial size, anatomy and function. Cardiovascular Ultrasound 10 4. (doi:10.1186/1476-7120-10-4)
Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S, Otsuji Y, Lang RM 2009 Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. Journal of the American Society of Echocardiography 22 70–75. (doi:10.1016/j.echo.2008.11.006)
Aurigemma GP, Gottdiener JS, Arnold AM, Chinali M, Hill JC, Kitzman D 2009 Left atrial volume and geometry in healthy aging: the Cardiovascular Health Study. Circulation: Cardiovascular Imaging 2 282–289. (doi:10.1161/CIRCIMAGING.108.826602)
Spencer KT, Mor-Avi V, Gorcsan J 3rd DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K et al 2001 Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart 85 272–277. (doi:10.1136/heart.85.3.272)
Thomas L, Levett K, Boyd A, Leung DY, Schiller NB, Ross DL 2002 Compensatory changes in atrial volumes with normal aging: is atrial enlargement inevitable? Journal of the American College of Cardiology 40 1630–1635. (doi:10.1016/S0735-1097(02)02371-9)
Boyd AC, Richards DA, Marwick T, Thomas L 2011 Atrial strain rate is a sensitive measure of alterations in atrial phasic function in healthy ageing. Heart 97 1513–1519. (doi:10.1136/heartjnl-2011-300134)
Echocardiographic Normal Ranges Meta-Analysis of the Left Heart Collaboration 2015 Ethnic-specific normative reference values for echocardiographic LA and LV size, LV mass, and systolic function: the EchoNoRMAL study. JACC Cardiovascular Imaging 8 656–665. (doi:10.1016/j.jcmg.2015.02.014)
Pritchett AM, Jacobsen SJ, Mahoney DW, Rodeheffer RJ, Bailey KR, Redfield MM 2003 Left atrial volume as an index of left atrial size: a population-based study. Journal of the American College of Cardiology 41 1036–1043. (doi:10.1016/S0735-1097(02)02981-9)
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, et al. 2015 Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography 28 1–39.e14. (doi:10.1016/j.echo.2014.10.003)
Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP 2009 Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. Journal of the American Society of Echocardiography 22 299–305. (doi:10.1016/j.echo.2008.12.017)
Kowallick JT, Kutty S, Edelmann F, Chiribiri A, Villa A, Steinmetz M, Sohns JM, Staab W, Bettencourt N, Unterberg-Buchwald C, et al. 2014 Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study. Journal of Cardiovascular Magnetic Resonance 16 60. (doi:10.1186/s12968-014-0060-6)
Hoit BD 2014 Left atrial size and function: role in prognosis. Journal of the American College of Cardiology 63 493–505. (doi:10.1016/j.jacc.2013.10.055)
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A 2009 Recommendations for the evaluation of left ventricular diastolic function by echocardiography. European Journal of Echocardiography 10 165–193. (doi:10.1093/ejechocard/jep007)
Cameli M, Caputo M, Mondillo S, Ballo P, Palmerini E, Lisi M, Marino E, Galderisi M 2009 Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking. Cardiovascular Ultrasound 7 6. (doi:10.1186/1476-7120-7-6)
Kurt M, Wang J, Torre-Amione G, Nagueh SF 2009 Left atrial function in diastolic heart failure. Circulation: Cardiovascular Imaging 2 10–15. (doi:10.1161/CIRCIMAGING.108.813071)
Barbier P, Solomon SB, Schiller NB, Glantz SA 1999 Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation 100 427–436. (doi:10.1161/01.CIR.100.4.427)
Todaro MC, Choudhuri I, Belohlavek M, Jahangir A, Carerj S, Oreto L, Khandheria BK 2012 New echocardiographic techniques for evaluation of left atrial mechanics. European Heart Journal Cardiovascular Imaging 13 973–984. (doi:10.1093/ehjci/jes174)
Sun JP, Yang Y, Guo R, Wang D, Lee AP, Wang XY, Lam YY, Fang F, Yang XS, Yu CM 2013 Left atrial regional phasic strain, strain rate and velocity by speckle-tracking echocardiography: normal values and effects of aging in a large group of normal subjects. International Journal of Cardiology 168 3473–3479. (doi:10.1016/j.ijcard.2013.04.167)
Saraiva RM, Demirkol S, Buakhamsri A, Greenberg N, Popovic´ ZB, Thomas JD, Klein AL 2010 Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. Journal of the American Society of Echocardiography 23 172–180. (doi:10.1016/j.echo.2009.11.003)
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The first author was the recipient of the Carnegie PhD Fellowship award.
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Meel, R., Khandheria, B.K., Peters, F. et al. Effects of age on left atrial volume and strain parameters using echocardiography in a normal black population. Echo Res Pract 3, 115–123 (2016). https://doi.org/10.1530/ERP-16-0038
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DOI: https://doi.org/10.1530/ERP-16-0038