Left ventricular and left atrial volume ratio assessed by three-dimensional echocardiography: Novel indices for evaluating age-related change in left heart chamber size.

Masaaki Takeuchi,Yosuke Nabeshima,Kyoko Otani,Yutaka Otsuji,Tetsuji Kitano

doi:10.14814/phy2.14300

Masaaki Takeuchi, Yosuke Nabeshima + Show 3 more

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https://doi.org/10.14814/phy2.14300

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Abstract

We hypothesized that left ventricular and left atrial volume ratio (LVLAVR) assessed by three‐dimensional echocardiography (3DE) reflects age‐ and gender‐related change in left chamber size. We aimed to (1) determine the reference values of LVLAVR, (2) investigate their age and gender dependency, and (3) clarify which anthropometric and echocardiography parameters are closely associated with these indices. Both left ventricular (LV) and left atrial (LA) volume curves were obtained using 3DE speckle tracking analytical software, and the LVLAVR curve throughout one cardiac cycle was created, from which LVLAVR at ventricular end‐diastole and at ventricular end‐systole were determined in 313 healthy subjects (age, 20–85 years; 51% men). The mean values of LVLAVR at ventricular end‐diastole and ventricular end‐systole in male subjects were 5.74 ± 1.54 and 1.37 ± 0.35, respectively. Corresponding values in female subjects were significantly lower (5.20 ± 1.47, p = .003 and 1.13 ± 0.29, p < .001) than the values in male subjects. LVLAVR at ventricular end‐diastole step wisely decreased to advanced aging, and had a highest F ratio compared with other left chamber volumetric parameters in both genders. LV mass and LA ejection fraction were significantly associated with LVLAVR at ventricular end‐diastole. In contrast, LV mass and LV ejection fraction were significantly coupled with LVLAVR at ventricular end‐systole. This study provides the reference values for LVLAVR from a relatively large number of healthy subjects. LVLAVR may be a sensitive parameter to reflect age‐ and gender‐related change in LV and LA volumes. Further studies should be required to determine its clinical usefulness over traditional echocardiography parameters in various cardiovascular diseases.

Highlights

Age- and gender-related change in left ventricular (LV) and left atrial (LA) volumes has been reported in healthy subjects (Badano et al, 2016; Kaku et al, 2011)
The mean values of left ventricular and left atrial volume ratio (LVLAVR) at ventricular end-diastole and at ventricular end-systole were 5.48 ± 1.53 and 1.25 ± 0.34, respectively, indicating that the LV volume was more than 5.5 times larger than the LA volume at ventricular end-diastole, and the LV volume was 1.3 times larger than the LA volume at ventricular end-systole
Intraobserver variability was assessed by having the observer to repeat the measurement of LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), maximal LA volume (LAVmax), minimal LA volume (LAVmin), LVLAVR at ventricular end-diastole

Summary

Introduction

Age- and gender-related change in left ventricular (LV) and left atrial (LA) volumes has been reported in healthy subjects (Badano et al, 2016; Kaku et al, 2011). Several studies have determined the reference values of LV volumes and LV ejection fraction (LVEF) (Aune, Baekkevar, Rodevand, & Otterstad, 2010; Bernard et al, 2017; Chahal et al, 2012; Fukuda et al, 2012; Kaku et al, 2011; Muraru et al, 2013). Some studies have addressed normal values of 3DE determined LA volumes, majority of current 3DE quantification software was not aimed for LA volume analysis, or it required extensive and tedious manual tracing on LA endocardial border at several time points of the cardiac cycle (Aune, Bækkevar, Roislien, Rodevand, & Otterstad, 2009; Badano et al, 2016; Russo et al, 2017; Wu et al, 2013). A novel semiautomatic 3DE software, which has capability of both LV and LA volume measurements throughout one cardiac cycle, has been developed

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