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

Normal 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.

In 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 (Ɛ_R) and contractile phase (Ɛ_CT).

No 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 Ɛ_R (P < 0.0001) in the older age groups, whereas Ɛ_CT remained unchanged (P = 0.27).

Age-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 Ɛ_R with advancing age. The preservation of Ɛ_CT with increasing age requires further analysis.