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

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.

Left atrial function: evaluation by strain analysis

“…Reference values for LA strain and strain rate have been reported (4). In a multicentre study involving 329 healthy subjects, Morris et (35). Similar findings were reported by Morris et al using 2D STE in healthy controls (32).…”

Cardiotoxicity in breast cancer treatment: What about left ventricular diastolic function and left atrial function?

“…Left atrial indexed volume remains the main echocardiographic parameter to assess the remodeling and indirectly the function of the LA and is a powerful prognostic tool . However, volumetric measures of LA function are limited by lower sensitivity in early disease states and can be increased due to other diseases .…”

“…LA strain parameters are usually higher in women, compared to men . With increasing age, it decreases progressively, being more pronounced in women, and independently of baseline characteristics such as blood pressure, LA volume or LV diastolic function . With increasing age, impaired LV relaxation reduces passive atrial conduit function and LA stiffness decreases reservoir function, limiting LV filling .…”

“…Left atrial indexed volume remains the main echocardiographic parameter to assess the remodeling and indirectly the function of the LA and is a powerful prognostic tool. [17][18][19][20] However, volumetric measures of LA function are limited by lower sensitivity in early disease states and can be increased due to other diseases. 19 LA myocardial analysis using 2DSTE identifies LA dysfunction despite normal LA ejection fraction and normal LA indexed volume in patients with LV diastolic dysfunction.…”

“…TA B L E 5 Significant changes in left atrial strain parameters as blood pressure, LA volume or LV diastolic function. [17][18][19][20][21] With increasing age, impaired LV relaxation reduces passive atrial conduit function and LA stiffness decreases reservoir function, limiting LV filling. 21 With senescence, LA contraction augments as a compensatory mechanism with a late decrease with further aging.…”