Reference right atrial dimensions and volume estimation by steady state free precession cardiovascular magnetic resonance

Abstract

BackgroundCardiovascular magnetic resonance (CMR) steady state free precession (SSFP) cine sequences with high temporal resolution and improved post-processing can accurately measure RA dimensions. We used this technique to define ranges for normal RA volumes and dimensions normalized, when necessary, to the influence of gender, body surface area (BSA) and age, and also to define the best 2D images-derived predictors of RA enlargement.MethodsFor definition of normal ranges of RA volume we studied 120 healthy subjects (60 men, 60 women; 20 subjects per age decile from 20 to 80 years), after careful exclusion of cardiovascular abnormality. We also studied 120 patients (60 men, 60 women; age range 20 to 80 years) with a clinical indication for CMR in order to define the best 1D and 2D predictors of RA enlargement. Data were generated from SSFP cine CMR, with 3-dimensional modeling, including tracking of the atrioventricular ring motion and time-volume curves analysis.ResultsIn the group of healthy individuals, age influenced RA 2-chamber area and transverse diameter. Gender influenced most absolute RA dimensions and volume. Interestingly, right atrial volumes did not change with age and gender when indexed to body surface area. New CMR normal ranges for RA dimensions were modeled and displayed for clinical use with normalization for BSA and gender and display of parameter variation with age. Finally, the best 2D images-derived independent predictors of RA enlargement were indexed area and indexed longitudinal diameter in the 2-chamber view.ConclusionReference RA dimensions and predictors of RA enlargement are provided using state-of-the-art CMR techniques.

Atrial remodelling is less pronounced in female endurance-trained athletes compared with that in male athletes

“…However, this is likely explained by the higher training load in female triathletes. This is supported by the reference values for LA and RA volumes presented by Maceira et al (11,12) showing there are no differences in atrial dimensions between the age groups 20-29 and 30-39.…”

“…Cut off values for normal atrial remodeling are often presented normalized for body surface area (BSA) (8)(9)(10)(11)(12). This form of scaling may be useful in a normal population where atrial volumes vary with BSA (11).…”

“…Left and right atrial volumes have in previous studies been measured using either echocardiography (7, 9, 10, 15, 16) or CMR (8,11,12,15,17). …”

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

“…Univariate analyses of survival compared with cardiac MRI measurements listed within Table 2 demonstrated significantly improved survival with higher RAEF (p < 0.0001, HR 0.83 per 5 % increase in RAEF, CI [0.77, 0.90]) or RVEF RA area [35]. RA length was measured from the midpoint of the tricuspid annular plane to the back wall of the right atrium ( Fig.…”

Diagnostic accuracy of standard axial 64-slice chest CT compared to cardiac MRI for the detection of cardiomyopathies

“…Quantitative measurements and techniques were referenced against standard published normal values (Table 2). [12][13][14][15][16] A confidence score for the presence of cardiomyopathy was given for each chest CT on a four-point scale (0 5 unconfident, 1 5 low confidence, 2 5 moderate confidence and 3 5 high Hypertrophic [16] Ischaemic [8] Other [4] F, female; M, male.…”