Atrial dilation and altered function are mediated by age and diastolic function but not before the eighth decade
Anita C Boyd1, Nelson B Schiller, Dominic Leung
1University of New South Wales, Sydney, New South Wales, Australia.
JACC. Cardiovascular Imaging
|March 19, 2011
Summary
Left atrial (LA) volumes increase significantly only in the eighth decade of life. Before this, changes in LA function are linked to age-related alterations in left ventricular diastolic relaxation.
Area of Science:
- Cardiology
- Gerontology
- Echocardiography
Background:
- Left atrial (LA) volume is a key indicator of cardiovascular disease and prognosis.
- Quantifying age-related physiological changes in LA volume is crucial for accurate pathological assessment.
Purpose of the Study:
- To investigate age-related changes in left atrial (LA) volumes and phasic function in healthy individuals.
- To establish normative data for LA volumes and function across different age deciles.
Main Methods:
- Transthoracic echocardiography in 220 healthy subjects (age 20-80 years).
- Measurement of LA volumes (maximum, minimum, pre-a-wave) and calculation of filling/emptying parameters.
- Analysis of transmitral inflow, pulmonary vein flow, and Doppler tissue imaging for diastolic function assessment.
- Stratification of subjects by age deciles for analysis.
Main Results:
- Left atrial indexed volumes (maximum and minimum) increased with age, becoming significant in the eighth decade.
- Impaired left ventricular diastolic relaxation was observed starting in the sixth decade.
- Age-related changes included decreased LA expansion index and passive emptying, with increased active emptying volume.
Conclusions:
- Left atrial indexed volumes remain stable until the eighth decade in healthy individuals.
- Significant LA enlargement before the eighth decade suggests underlying pathology.
- Altered left ventricular diastolic relaxation precedes significant changes in LA volumes, influencing phasic atrial function.
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