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

Ruchika Meel, Bijoy K. Khandheria, Ferande Peters, Elena Libhaber, Samantha Nel, Mohammed R. Essop

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 [ƐR] and contractile phase [ƐCT]. 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 ƐR (P<0.0001) in the older age groups, whereas ƐCT 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 ƐR with advancing age. The preservation of ƐCT with increasing age requires further analysis.