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01-06-2012 | Echocardiography (RM Lang, Section Editor)

Left Atrial Volume: Clinical Value Revisited

Authors: Michael Y. C. Tsang, Marion E. Barnes, Teresa S. M. Tsang

Published in: Current Cardiology Reports | Issue 3/2012

Abstract

Left atrial (LA) volume and function are robust markers of cardiovascular risks and adverse cardiac outcomes. With advances in imaging technology, including tissue Doppler, strain, and strain rate imaging, we can now determine LA volume and function more precisely and this is anticipated to augment our ability to risk stratify, incremental to clinical risk profiling. There is increasing evidence that LA remodeling is treatable and is reversible. Serial LA volume and function assessment may provide a simple and quantifiable way of determining severity of risk and treatment impact. While reverse LA remodeling is expected to improve cardiac outcomes, data to confirm this remain forthcoming.

Tsang TSM, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002;90(12):1284–9.PubMedCrossRef

Pritchett AM, Mahoney DW, Jacobsen SJ, Rodeheffer RJ, Karon BL, Redfield MM. Diastolic dysfunction and left atrial volume: a population-based study. J Am Coll Cardiol. 2005;45(1):87–92.PubMedCrossRef

Hoogsteen J, Hoogeveen A, Schaffers H, Wijn PFF, van der Wall EE. Left atrial and ventricular dimensions in highly trained cyclists. Int J Card Imag. 2003;19(3):211–7.CrossRef

Lai ZY, Chang NC, Tsai MC, Lin CS, Chang SH, Wang TC. Left ventricular filling profiles and angiotensin system activity in elite baseball players. Int J Cardiol. 1998;67(2):155–60.PubMedCrossRef

Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study. Circulation. 1994;89(2):724–30.PubMed

Tsang TS, Barnes ME, Bailey KR, Leibson CL, Montgomery SC, Takemoto Y, et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001;76(5):467–75.PubMedCrossRef

Takemoto Y, Barnes ME, Seward JB, Lester SJ, Appleton CA, Gersh BJ, et al. Usefulness of left atrial volume in predicting first congestive heart failure in patients > or = 65 years of age with well-preserved left ventricular systolic function. Am J Cardiol. 2005;96(6):832–6.PubMedCrossRef

Gottdiener JS, Kitzman DW, Aurigemma GP, Arnold AM, Manolio TA. Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons > or =65 years of age (the cardiovascular health study). Am J Cardiol. 2006;97(1):83–9.PubMedCrossRef

Benjamin EJ, D’Agostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation. 1995;92(4):835–41.PubMed

10.

Barnes ME, Miyasaka Y, Seward JB, Gersh BJ, Rosales AG, Bailey KR, et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc. 2004;79(8):1008–14.PubMedCrossRef

11.

Fatema K, Bailey KR, Petty GW, Meissner I, Osranek M, Alsaileek AA, et al. Increased left atrial volume index: potent biomarker for first-ever ischemic stroke. Mayo Clin Proc. 2008;83(10):1107–15.PubMedCrossRef

12.

Tsang TSM, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, et al. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol. 2006;47(5):1018–23.PubMedCrossRef

13.

Tsang TSM, Barnes ME, Gersh BJ, Takemoto Y, Rosales AG, Bailey KR, et al. Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography. J Am Coll Cardiol. 2003;42(7):1199–205.PubMedCrossRef

14.

Leung DY, Chi C, Allman C, Boyd A, Ng AC, Kadappu KK, et al. Prognostic implications of left atrial volume index in patients in sinus rhythm. Am J Cardiol. 2010;105(11):1635–9.PubMedCrossRef

15.

Osranek M, Fatema K, Qaddoura F, Al-Saileek A, Barnes ME, Bailey KR, et al. Left atrial volume predicts the risk of atrial fibrillation after cardiac surgery: a prospective study. J Am Coll Cardiol. 2006;48(4):779–86.PubMedCrossRef

16.

Hoglund C, Rosenhamer G. Echocardiographic left atrial dimension as a predictor of maintaining sinus rhythm after conversion of atrial fibrillation. Acta Medica Scandinavica. 1985;217(4):411–5.PubMedCrossRef

17.

• Marchese P, Malavasi V, Rossi L, Nikolskaya N, Donne GD, Becirovic M et al. Indexed left atrial volume is superior to left atrial diameter in predicting nonvalvular atrial fibrillation recurrence after successful cardioversion: A prospective study. Echocardiography. 2012; In Press. doi:10.1111/j.1540-8175.2011.01577.x. In this prospective study of 76 subjects undergoing cardioversion for AF, 68.4 % experienced AF recurrence. In a multivariable model, indexed LA volume remained the only independent predictor of recurrence; anteroposterior LA diameter was not associated with AF recurrence.

18.

Berruezo A, Tamborero D, Mont L, Benito B, Tolosana JM, Sitges M, et al. Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. Eur Hear J. 2007;28(7):836–41.CrossRef

19.

Hof I, Chilukuri K, Arbab-Zadeh A, Scherr D, Dalal D, Nazarian S, et al. Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? J Cardiovasc Electrophysiol. 2009;20(9):1005–10.PubMedCrossRef

20.

Tsang TSM. Echocardiography in cardiovascular public health: the Feigenbaum Lecture 2008. J Am Soc Echocardiogr. 2009;22(6):649–56. quiz 751-2.PubMedCrossRef

21.

Lester SJ, Ryan EW, Schiller NB, Foster E. Best method in clinical practice and in research studies to determine left atrial size. Am J Cardiol. 1999;84(7):829–32.PubMedCrossRef

22.

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.PubMedCrossRef

23.

Kircher B, Abbott JA, Pau S, Gould RG, Himelman RB, Higgins CB, et al. Left atrial volume determination by biplane two-dimensional echocardiography: validation by cine computed tomography. Am Hear J. 1991;121(3 Pt 1):864–71.CrossRef

24.

Himelman RB, Cassidy MM, Landzberg JS, Schiller NB. Reproducibility of quantitative two-dimensional echocardiography. Am Hear J. 1988;115(2):425–31.CrossRef

25.

Rodevan O, Bjornerheim R, Ljosland M, Maehle J, Smith HJ, Ihlen H. Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. Int J Cardiac Imag. 1999;15(5):397–410.CrossRef

26.

Poutanen T, Jokinen E, Sairanen H, Tikanoja T. Left atrial and left ventricular function in healthy children and young adults assessed by three dimensional echocardiography. Heart. 2003;89(5):544–9.PubMedCrossRef

27.

Vandenberg BF, Weiss RM, Kinzey J, Acker M, Stark CA, Stanford W, et al. Comparison of left atrial volume by two-dimensional echocardiography and cine-computed tomography. Am J Cardiol. 1995;75(10):754–7.PubMedCrossRef

28.

Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009;10(2):165–93.PubMedCrossRef

29.

Faletra F, La Marchesina U, Bragato R, De Chiara F. Three dimensional transthoracic echocardiography images of tricuspid stenosis. Heart. 2005;91(4):499.PubMedCrossRef

30.

• Caselli S, Canali E, Foschi ML, Santini D, Di Angelantonio E, Pandian NG, et al. Long-term prognostic significance of three-dimensional echocardiographic parameters of the left ventricle and left atrium. Eur J Echocardiogr. 2010;11(3):250–6. In this prospective study, subjects referred for clinically indicated echocardiograms underwent both 2D and three-dimensional (3D) echocardiographic imaging at baseline. After 45 months follow-up for events, a multivariable model revealed LA minimum volume by 3D echocardiography to be the strongest independent predictor of major cardiac events.PubMedCrossRef

31.

Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47(12):2357–63.PubMedCrossRef

32.

Mitchell JH, Shapiro W. Atrial function and the hemodynamic consequences of atrial fibrillation in man. Am J Cardiol. 1969;23(4):556–67.PubMedCrossRef

33.

Prioli A, Marino P, Lanzoni L, Zardini P. Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol. 1998;82(6):756–61.PubMedCrossRef

34.

Spencer KT, Mor-Avi V, Gorcsan 3rd J, DeMaria AN, Kimball TR, Monaghan MJ, et al. Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart. 2001;85(3):272–7.PubMedCrossRef

35.

Triposkiadis F, Tentolouris K, Androulakis A, Trikas A, Toutouzas K, Kyriakidis M, et al. Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr. 1995;8(6):801–9.PubMedCrossRef

36.

•• Kurt M, Wang J, Torre-Amione G, Nagueh SF. Left atrial function in diastolic heart failure. Circ Cardiovasc Imag. 2009;2(1):10–5. This study utilized simultaneous right heart catheterization and strain echocardiography to compare LA function indices in subjects with diastolic HF versus those with diastolic dysfunction without failure. Analysis showed LA strain during systole was significantly reduced and LA stiffness increased in those with HF symptoms versus those with diastolic abnormalities without failure.CrossRef

37.

Tsang TSM, Barnes ME, Cha SS, et al. Role of atrial function in first ischemic stroke: a prospective study. J Am Soc Echocardiogr. 2012; In press.

38.

Abhayaratna WP, Fatema K, Barnes ME, Seward JB, Gersh BJ, Bailey KR, et al. Left atrial reservoir function as a potent marker for first atrial fibrillation or flutter in persons > or = 65 years of age. Am J Cardiol. 2008;101(11):1626–9.PubMedCrossRef

39.

Manning WJ, Leeman DE, Gotch PJ, Come PC. Pulsed Doppler evaluation of atrial mechanical function after electrical cardioversion of atrial fibrillation. J Am Coll Cardiol. 1989;13(3):617–23.PubMedCrossRef

40.

Manning WJ, Silverman DI, Katz SE, Riley MF, Doherty RM, Munson JT, et al. Temporal dependence of the return of atrial mechanical function on the mode of cardioversion of atrial fibrillation to sinus rhythm. Am J Cardiol. 1995;75(8):624–6.PubMedCrossRef

41.

Manning WJ, Silverman DI, Katz SE, Riley MF, Come PC, Doherty RM, et al. Impaired left atrial mechanical function after cardioversion: relation to the duration of atrial fibrillation. J Am Coll Cardiol. 1994;23(7):1535–40.PubMedCrossRef

42.

Bukachi F, Waldenstrom A, Morner S, Lindqvist P, Henein MY, Kazzam E. Pulmonary venous flow reversal and its relationship to atrial mechanical function in normal subjects–Umea General Population Heart Study. Eur J Echocardiogr. 2005;6(2):107–16.PubMedCrossRef

43.

Xie GY, Berk MR, Fiedler AJ, Sapin PM, Smith MD. Left atrial function in congestive heart failure: assessment by transmitral and pulmonary vein Doppler. Int J Cardiac Imag. 1998;14(1):47–53.CrossRef

44.

Thomas L, Levett K, Boyd A, Leung DYC, Schiller NB, Ross DL. Changes in regional left atrial function with aging: evaluation by Doppler tissue imaging. Eur J Echocardiogr. 2003;4(2):92–100.PubMedCrossRef

45.

Wang M, Yip GWK, Wang AYM, Zhang Y, Ho PY, Tse MK, et al. Peak early diastolic mitral annulus velocity by tissue Doppler imaging adds independent and incremental prognostic value. J Am Coll Cardiol. 2003;41(5):820–6.PubMedCrossRef

46.

Appleton CP. Hemodynamic determinants of Doppler pulmonary venous flow velocity components: new insights from studies in lightly sedated normal dogs. J Am Coll Cardiol. 1997;30(6):1562–74.PubMedCrossRef

47.

Nakatani S, Garcia MJ, Firstenberg MS, Rodriguez L, Grimm RA, Greenberg NL, et al. Noninvasive assessment of left atrial maximum dP/dt by a combination of transmitral and pulmonary venous flow. J Am Coll Cardiol. 1999;34(3):795–801.PubMedCrossRef

48.

Ho CY, Solomon SD. A clinician’s guide to tissue Doppler imaging. Circulation. 2006;113(10):e396–8.PubMedCrossRef

49.

Rivas-Gotz C, Manolios M, Thohan V, Nagueh SF. Impact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue Doppler and flow propagation velocity. Am J Cardiol. 2003;91(6):780–4.PubMedCrossRef

50.

Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30(6):1527–33.PubMedCrossRef

51.

Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study. Circulation. 2000;102(15):1788–94.PubMed

52.

Blessberger H, Binder T. Two dimensional speckle tracking echocardiography: clinical applications. Heart. 2010;96(24):2032–40.PubMedCrossRef

53.

Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TSM, Appleton CP. Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr. 2009;22(3):299–305.PubMedCrossRef

54.

Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;8:14.PubMedCrossRef

55.

To ACY, Flamm SD, Marwick TH, Klein AL. Clinical utility of multimodality LA imaging: assessment of size, function, and structure. Jacc: Cardiovasc Imag. 2011;4(7):788–98.CrossRef

56.

Boyd AC, Schiller NB, Ross DL, Thomas L. Segmental atrial contraction in patients restored to sinus rhythm after cardioversion for chronic atrial fibrillation: a colour Doppler tissue imaging study. Eur J Echocardiogr. 2008;9(1):12–7.PubMed

57.

Thomas L, McKay T, Byth K, Marwick TH. Abnormalities of left atrial function after cardioversion: an atrial strain rate study. Heart. 2007;93(1):89–95.PubMedCrossRef

58.

Schneider C, Malisius R, Krause K, Lampe F, Bahlmann E, Boczor S, et al. Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Hear J. 2008;29(11):1397–409.CrossRef

59.

Di Salvo G, Caso P, Lo Piccolo R, Fusco A, Martiniello AR, Russo MG, et al. Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study. Circulation. 2005;112(3):387–95.PubMedCrossRef

60.

Kokubu N, Yuda S, Tsuchihashi K, Hashimoto A, Nakata T, Miura T, et al. Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension: a possible beneficial effect of renin-angiotensin system inhibition on left atrial function. Hypertens Res-Clin Exp. 2007;30(1):13–21.CrossRef

61.

Eshoo S, Semsarian C, Ross DL, Marwick TH, Thomas L. Comparison of left atrial phasic function in hypertrophic cardiomyopathy versus systemic hypertension using strain rate imaging. Am J Cardiol. 2011;107(2):290–6.PubMedCrossRef

62.

Paraskevaidis IA, Panou F, Papadopoulos C, Farmakis D, Parissis J, Ikonomidis I, et al. Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: a tissue Doppler imaging and two-dimensional strain study. Heart. 2009;95(6):483–9.PubMedCrossRef

63.

Gabrielli L, Cordova S, Yanez F, Enriquez A, Fasce F, Godoy I. The assessment of left atrial function by 2-dimensional speckle tracking allows to differentiate between hypertrophic cardiomyopathy and athlete’s heart. J Am Coll Cardiol. 2011;57:E715.CrossRef

64.

Vasan RS, Larson MG, Levy D, Evans JC, Benjamin EJ. Distribution and categorization of echocardiographic measurements in relation to reference limits: the Framingham Heart Study: formulation of a height- and sex-specific classification and its prospective validation. Circulation. 1997;96(6):1863–73.PubMed

65.

Pritchett AM, Jacobsen SJ, Mahoney DW, Rodeheffer RJ, Bailey KR, Redfield MM. Left atrial volume as an index of left atrial size: a population-based study. J Am Coll Cardiol. 2003;41(6):1036–43.PubMedCrossRef

66.

Wang Y, Gutman JM, Heilbron D, Wahr D, Schiller NB. Atrial volume in a normal adult population by two-dimensional echocardiography. Chest. 1984;86(4):595–601.PubMedCrossRef

67.

Knutsen KM, Stugaard M, Michelsen S, Otterstad JE. M-mode echocardiographic findings in apparently healthy, non-athletic Norwegians aged 20-70 years. Influence of age, sex and body surface area. J Intern Med. 1989;225(2):111–5.PubMedCrossRef

68.

Kennedy JW, Yarnall SR, Murray JA, Figley MM. Quantitative angiocardiography. IV. Relationships of left atrial and ventricular pressure and volume in mitral valve disease. Circulation. 1970;41(5):817–24.PubMed

69.

Dalsgaard M, Egstrup K, Wachtell K, Gerdts E, Cramariuc D, Kjaergaard J, et al. Left atrial volume in patients with asymptomatic aortic valve stenosis (the Simvastatin and Ezetimibe in Aortic Stenosis study). Am J Cardiol. 2008;101(7):1030–4.PubMedCrossRef

70.

Casaclang-Verzosa G, Gersh BJ, Tsang TSM. Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J Am Coll Cardiol. 2008;51(1):1–11.PubMedCrossRef

71.

Greenberg B, Chatterjee K, Parmley WW, Werner JA, Holly AN. The influence of left ventricular filling pressure on atrial contribution to cardiac output. Am Hear J. 1979;98(6):742–51.CrossRef

72.

D’Andrea A, Riegler L, Cocchia R, Scarafile R, Salerno G, Gravino R, et al. Left atrial volume index in highly trained athletes. Am Hear J. 2010;159(6):1155–61.CrossRef

73.

Pelliccia A, Maron BJ, Di Paolo FM, Biffi A, Quattrini FM, Pisicchio C, et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol. 2005;46(4):690–6.PubMedCrossRef

74.

Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete’s heart. A meta-analysis of cardiac structure and function. Circulation. 2000;101(3):336–44.PubMed

75.

Mont L, Sambola A, Brugada J, Vacca M, Marrugat J, Elosua R, et al. Long-lasting sport practice and lone atrial fibrillation. Eur Hear J. 2002;23(6):477–82.CrossRef

76.

Karjalainen J, Kujala UM, Kaprio J, Sarna S, Viitasalo M. Lone atrial fibrillation in vigorously exercising middle aged men: case-control study. BMJ. 1998;316(7147):1784–5.PubMedCrossRef

77.

Tsang TSM, Gersh BJ, Appleton CP, Tajik AJ, Barnes ME, Bailey KR, et al. Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women. J Am Coll Cardiol. 2002;40(9):1636–44.PubMedCrossRef

78.

Rossi A, Cicoira M, Zanolla L, Sandrini R, Golia G, Zardini P, et al. Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2002;40(8):1425.PubMedCrossRef

79.

Losi M-A, Betocchi S, Barbati G, Parisi V, Tocchetti C-G, Pastore F, et al. Prognostic significance of left atrial volume dilatation in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2009;22(1):76–81.PubMedCrossRef

80.

Tsang TSM, Barnes ME, Abhayaratna WP, Cha SS, Gersh BJ, Langins AP, et al. Effects of quinapril on left atrial structural remodeling and arterial stiffness. Am J Cardiol. 2006;97(6):916–20.PubMedCrossRef

81.

Gerdts E, Wachtell K, Omvik P, Otterstad JE, Oikarinen L, Boman K, et al. Left atrial size and risk of major cardiovascular events during antihypertensive treatment: losartan intervention for endpoint reduction in hypertension trial. Hypertension. 2007;49(2):311–6.PubMedCrossRef

Title: Left Atrial Volume: Clinical Value Revisited
Authors: Michael Y. C. Tsang
Marion E. Barnes
Teresa S. M. Tsang
Publication date: 01-06-2012
Publisher: Current Science Inc.
Published in: Current Cardiology Reports / Issue 3/2012
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-012-0268-8

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