Effect of ageing on left atrial geometry and function assessed by three-dimensional echocardiography

Background: Left atrial (LA) size and function are well-known predictors of cardiovascular outcome. Our aim was to evaluate age-related changes in LA volumes and function in healthy subjects using a novel prototype 3D software dedicated for atrium quantitation. Methods: 65 healthy volunteers aged 18 to 65 (38+12 years, 34 men) and good acoustic window underwent 3D LA full-volume acquisition from apical approach (31+6 vps). LA data sets were analyzed with a semi-automated software (TomTec, Unterschleissheim, D). LA volumes (LAV max; min; preA = LAV before LA contraction) and LA function indexes were provided. Results: LA indexes derived from a single 3D LA data set analysis (average time 4′10′′) are summarized in Table. Age was positively correlated with all LA volumes (LAV max r=0.32, min r=0.30, preA r=0.42, p,0.02 for all). Both active and total LA ejection fraction were marginally correlated with age (r=-0.24 and r=0.24, p=0.05 for both). LA active stroke volume increased with ageing (r=0.43, p,0.001), the active LA contribution ranging from 26+8% of total LA stroke volume in subjects ,30 years to 35+10% in subjects .50 years (p ANOVA=0.02). Conversely, LA total stroke volume or LA sphericity were not age-related. Intraclass correlation coefficients for LAV max, min and preA were 0.98, 0.93, 0.94 for intraobserver and 0.82, 0.66, 0.80 for interobserver reproducibility, respectively. Conclusions: The tested software dedicated for LA quantitation on 3D data sets works fairly rapid and reproducible, enabling the detection of age-related changes in LA size and function. Reference values are provided for clinical testing of this new LA software