103 Normal values and gender differences of left atrial volumes

Abstract

Abstract Funding Acknowledgements Vestre Viken Hospital Trust Background Left atrial (LA) enlargement is associated with cardiovascular morbidity and mortality. Echocardiographic guidelines recommend body surface area (BSA) indexed LA end-systolic volume (LAVimax) in the assessment of LA size with an upper normal limit of 34 ml/m² for both genders and all age groups. LA end-diastolic volume (LAVimin) and LA emptying fraction (LAEF) may add valuable information in risk assessment, but there are limited data on normal values. Purpose To add knowledge and explore gender differences of LA volumetric measures. Methods In The Akershus Cardiac Examination 1950 Study, all inhabitants of Akershus County, Norway, born in 1950 were invited. In 3,489 individuals LAVmax and LAVmin were measured with echocardiography according to the summation of discs method and indexed to BSA. LAEF was calculated. A healthy group was defined by excluding those with heart failure, atrial fibrillation, coronary artery disease, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, body mass index > 30kg/m², eGFR < 60 ml/min/1.73 m², left ventricular ejection fraction < 50%, E/e’>14 and E/A > 2.0. Data are presented as mean ± standard deviation (SD) and a normal range of mean ± 2SD. T-tests were used for comparisons. Results In 840 healthy individuals, aged 63.8 ± 0.6 years, mean LAVimax was 25.6 ± 6.3 ml/m² and the normal range was 13.0-38.2 ml/m². Men had significantly larger volumes than women. Conclusion We present LA volumes and LAEF in a large cohort from the general population at age 64. The upper normal limit of LAVimax in 840 healthy individuals was 38 ml/m². Men had larger LA volumes than women, contrary to most previous studies. Thus, 13% of the healthy men in our cohort would be defined with an enlarged atrium with the current cut-off value at 34 ml/m². Table. Left atrial (LA) volumes and LAEF Total (mean ± SD) Total (2SD range) Male (mean ± SD) Female (mean ± SD) P-value (male vs. female) All participants (n = 3489) LAVimax (ml/m²) 26.8 ± 7.6 11.6-42.0 27.9 ± 8.1 25.6 ± 6.8 <0.001 LAVimin (ml/m²) 14.7 ± 5.8 3.1-26.3 15.5 ± 6.5 13.9 ± 4.9 <0.001 LAEF (%) 45.6 ± 9.7 26.2-65.0 45.3 ± 10.2 45.9 ± 9.2 0.07 Healthy group (n = 840) LAVimax (ml/m²) 25.6 ± 6.3 13.0-38.2 26.6 ± 6.7 24.9 ± 5.8 <0.001 LAVimin (ml/m²) 13.7 ± 4.3 5.1-22.3 14.1 ± 4.6 13.3 ± 3.9 0.008 LAEF (%) 46.8 ± 8.8 29.2-64.4 47.0 ± 9.1 46.5 ± 8.4 0.37 LAVimax, LA end-systolic volume, body surface area (BSA)-indexed; LAVimin, LA end-diastolic volume, BSA-indexed; LAEF, LA emptying fraction; SD, standard deviation