[Influence of age of patients with atrial fibrillation on left atrium function]

Frequency of occurrence of atrial fibrillation (FA) increases with age. In the elderly this arrhythmia might influence the enlargement and function of left atrium (LA) and its appendage (LAA). The aim of this study was to assess the association between age of patients and selected echocardiographic parameters concerning left atrium.

120 consecutive patients (52 women and 68 men) with FA were studied 36-89 years old (mean 68.7 +/- 10.9). Patients were divided into two groups using a cut-off value age of 70 years. Older than 70 years were 64 patients, whereas below this age were 56 persons. Duration time of arrhythmia did not differ significantly between studied groups. In all patients transthoracic (TTE) and transoesophageal (TEE) echocardiography were performed to assess selected echocardiographic parameters concerning left atrium (LA) and its appendage (LAA). During TTE were measured: LA maximal diameter in M-mode (LAmax), LA transversal diameter in 4-CH (LAtrans), LA longitudinal diameter in 4-CH (LAlong), LA circulum in 4-CH (LAcirc), LA area in 4-CH (LAarea). Consequently TEE was done to assess LAA transversal diameter (LAAtrans), LAA longitudinal diameter (LAAlong), LAA circulum (LAAcirc), LAA area (LAAarea), spontaneous echocardiographic contrast (SEC), thrombus (THR), maximal LAA outflow velocity (LAAF), maximal LAA inflow velocity (LAAB), integral of LAA outflow velocity (LAAFintg) and integral of LAA inflow velocity (LAABintg).

LAmax (4.91 +/- 0.61 vs. 4.22 +/- 0.49), LAtrans (4.75 +/- 0.71 vs. 4.11 +/- 0.44) and LAarea (31.85 +/- 6.9 vs. 27.51 +/- 6.54) were significantly greater in older patients compared to those below 70 years old. LAlong, LAcirc, LAarea, LAA trans, LAAlong, LAAcirc did not differ between studied groups. Thrombi in LAA were detected rarely in study population and were found often in older patients (in 2 vs. 6 patients). In almost 2/3 older patients SEC in LAA was visualized, which was markedly frequent when compared to younger group. In older patients parameters characterizing LAA function had significantly lower values than in younger patients (LAAF respectively 19.8 +/- 9.16 vs. 28.57 +/- 10.7, LAAB respectively 21.6 +/- 8.12 vs. 31.81 +/- 10.88).

In patients with atrial fibrillation left atrium and its appendage diameters are greater in the elderly. Left atrium appendage function is more deteriorated in older patients with atrial fibrillation. During atrial fibrillation thrombus formation and appearance of spontaneous echocardiographic contrast is more often in the elderly.