Effects of age on left atrial volume and strain parameters using echocardiography in a normal black population.

Ruchika Meel,Elena Libhaber,Samantha Nel,Mohammed R Essop,Bijoy K Khandheria,Ferande Peters

doi:10.1530/erp-16-0038

Abstract

ObjectiveNormal 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.MethodsIn 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).ResultsNo 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).ConclusionAge-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.

Highlights

The left atrium (LA) has been described as a gauge of diastolic burden, and disturbances in its function can result in impairment of overall cardiac performance (1, 2)
The study population was recruited from unrelated staff at Baragwanath Hospital and volunteers who presented themselves to the echocardiography laboratory after an advertisement about this study
This study provides normative age-related data for left atrial (LA) volumetric parameters and LA strain in a black African population

Summary

Introduction

The left atrium (LA) has been described as a gauge of diastolic burden, and disturbances in its function can result in impairment of overall cardiac performance (1, 2). The function of the LA, determined by various echo methods, predicts clinical outcome and mortality in several cardiovascular disorders (3, 4, 5). Various echocardiographic techniques, including linear dimensions of the LA, volumetric LA measurements and peak LA strain, have been studied to evaluate LA function (6, 7, 8, 9). The use of normative values from these techniques is essential to differentiate normality from milder disease in a variety of disease states. There are 2 important factors that may affect the interpretation of some of these measurements: age and ethnicity.

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Results

Conclusion