Reference values of left and right atrial volumes and phasic function based on a large sample of healthy Chinese adults: A cardiovascular magnetic resonance study

Yiyuan Gao,Zhen Zhang,Shanshan Zhou,Gengxiao Li,Mingwu Lou,Zhiwei Zhao,Jun Zhao,Kuncheng Li,Gerald M Pohost

doi:10.1016/j.ijcard.2022.01.071

Abstract

BackgroundThe left and right atrial (LA and RA) size and function are tightly linked to the morbidity and mortality of multiple cardiovascular diseases. We aimed to establish cardiovascular magnetic resonance (CMR) reference values for LA and RA volumes and phasic function based on a large sample of healthy Chinese adults. Methods408 validated healthy Chinese adults (54% men; aged 21–70 years) were included. LA and RA maximum, minimum, and pre-atrial contraction volumes (Vmax, Vmin, and Vpac); total, passive, and booster emptying fractions (EF total, EF passive, and EF booster); and total, passive, and active emptying volumes (TEV, PEV, and AEV) were measured on cine CMR. Normal reference values were calculated and were stratified by sex and age decades. ResultsMen demonstrated greater LAVmax, LAVmin, LAVpac, LAPEV, RAVmax, RAVmin, RAVpac, RATEV, and RAAEV, while women had higher LAEF total, LAEF booster, RAEF total, RAEF passive, and RAEF booster (all p < 0.05). Age was positively correlated with LAVpac and RAVpac in both sexes but was positively correlated with LAVmax, LAVmin, RAVmax, and RAVmin only in women (all p < 0.05). For both sexes, aging was associated with decreased LAEF total, LAEF passive, RAEF total, and RAEF passive, but increased LAEF booster (all p < 0.05). ConclusionWe systematically provide age- and sex-specific CMR reference values for LA and RA volumes and phasic function based on a large sample of healthy Chinese adults with a wide age range. Both age and sex are closely associated with biatrial volumes and function.

Highlights

The left and right atrium (LA and RA) play an integral role in modulating ventricular filling with its reservoir, conduit, and booster pump function [1,2,3]
The present study aimed to systematically establish age- and sex-specific cardiovascular magnetic resonance (CMR) reference values for LA, RA volumes and phasic function based on a large sample of healthy Chinese adults free of hypertension, diabetes, and obesity, and further investigate their associations with age and sex
There were excellent intra- and inter-observer reproducibility with intraclass correlation coefficients (ICC) of more than 0.85 in both LA and RA volumes. In this CMR study, we systematically established age- and sex-specific reference values for LA, RA volumes and phasic function based on a large sample of validated healthy Chinese adults free of hypertension, diabetes, and obesity

Summary

Introduction

The left and right atrium (LA and RA) play an integral role in modulating ventricular filling with its reservoir, conduit, and booster pump function [1,2,3]. Evidence is available that there are significant racial differences in atrial size and function [14, 15], emphasizing the necessity of the establishment of ethnic-specific normal values for atrial structure and function. A few studies have reported normal reference values of LA and RA volumes and function for Chinese adults [16, 17], their provided parameters are less comprehensive and are based on limited sample size. The present study aimed to systematically establish age- and sex-specific CMR reference values for LA, RA volumes and phasic function based on a large sample of healthy Chinese adults free of hypertension, diabetes, and obesity, and further investigate their associations with age and sex

Objectives

Methods

Conclusion