Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance
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RESEARCH
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Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance Alicia M Maceira1, Juan CosÃn-Sales2, Michael Roughton3, Sanjay K Prasad4, Dudley J Pennell4*
Abstract Background: Left atrial (LA) size is related to cardiovascular morbidity and mortality. Cardiovascular magnetic resonance (CMR) provides high quality images of the left atrium with high temporal resolution steady state free precession (SSFP) cine sequences. We used SSFP cines to define normal ranges for LA volumes and dimensions relative to gender, age and body surface area (BSA), and examine the relative value of 2D atrial imaging techniques in patients. For definition of normal ranges of LA volume we studied 120 healthy subjects after careful exclusion of cardiovascular abnormality (60 men, 60 women; 20 subjects per age decile from 20 to 80 years). Data were generated from 3-dimensional modeling, including tracking of the atrioventricular ring motion and time-volume curves analysis. For definition of the best 2D images-derived predictors of LA enlargement, we studied 120 patients (60 men, 60 women; age range 20 to 80 years) with a clinical indication for CMR. Results: In the healthy subjects, age was associated with LA 4-chamber transverse and 3-chamber anteroposterior diameters, but not with LA volume. Gender was an independent predictor of most absolute LA dimensions and volume, but following normalization to BSA, some associations became non-significant. CMR normal ranges were modeled and are tabled for clinical use with normalization, where appropriate, for BSA and gender and display of parameter variation with age. The best 2D predictors of LA volume were the 2-chamber area and 3-chamber area (both r = 0.90, p < 0.001). Conclusions: These CMR data show that LA dimensions and volume in healthy, individuals vary significantly by BSA, with lesser effects of age and gender.
Background Left atrial (LA) size represents the integration of LV diastolic performance over time and is considered a reliable indicator of the duration and severity of diastolic dysfunction [1], regardless of whatever loading conditions are present at the time of the examination. It provides significant prognostic information both in the general population and in patients with heart disease including heart failure [2-4], acute myocardial infarction [5-8], cardiomyopathy [9,10], and mitral regurgitation [11]. LA enlargement is commonly found in hypertensive heart disease [12,13] and it is a risk factor for atrial fibrillation * Correspondence: [email protected] 4 Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK Full list of author information is available at the end of the article
and stroke, especially in men [14,15], and for atrial fibrillation recurrence following therapy [16,17]. In the clinical setting, LA diameters and areas are usually measured, though LA volume is a more robust marker of cardiovascular events [18]. Cardiovascular magnetic resonance (CMR) has been ap
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