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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2017

Open Access 01-12-2016 | Research

Characterization of left and right atrial function in healthy volunteers by cardiovascular magnetic resonance

Authors: Alicia M. Maceira, Juan Cosin-Sales, Sanjay K. Prasad, Dudley J. Pennell

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

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Abstract

Background

Left and right atrial function show a different pattern in advanced age in order to maintain adequate ventricular filling. It has been shown that left atrial (LA) function has a prognostic value in a number of heart conditions. Cardiovascular magnetic resonance (CMR) provides high quality images of the left and right atria using high temporal resolution steady state free precession (SSFP) cine sequences. We used SSFP cines to characterize atrial function in healthy, normotensive, volunteers.

Methods

We measured maximum, preatrial contraction and minimum left and right atrial volumes in 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. With those measurements, all the usual parameters for left and right atrial function were calculated.

Results

Gender had significant influence on some parameters of left and right atrial conduit and booster pump function. Age significantly influenced the majority of parameters of both left and right atrial function, with typically lower reservoir and conduit functions and higher booster pump function, both in males and females belonging to older age groups. CMR normal ranges were modelled for clinical use with normalization, where appropriate, for body surface area and gender, displaying parameters with respect to age.

Conclusions

CMR normal reference ranges for components of left and right atrial function are provided for males and females for a wide age range.
Literature
1.
Wong JM, Welles CC, Azarbal F, Whooley MA, Schiller NB, Turakhia MP. Relation of left atrial dysfunction to ischemic stroke in patients with coronary heart disease (from the heart and soul study). Am J Cardiol. 2014;113:1679–84.CrossRefPubMed
2.
Welles CC, Ku IA, Kwan DM, Whooley MA, Schiller NB, Turakhia MP. Left Atrial Function Predicts Heart Failure Hospitalization in Subjects With Preserved Ejection Fraction and Coronary Heart Disease Longitudinal Data From the Heart and Soul Study. J Am Coll Cardiol. 2012;59:673–80.CrossRefPubMedPubMedCentral
3.
Pellicori P, Zhang J, Lukaschuk E, Joseph AC, Bourantas CV, Loh H, Bragadeesh T, Clark AL, Cleland JG. Left atrial function measured by cardiac magnetic resonance imaging in patients with heart failure: clinical associations and prognostic value. Eur Heart J. 2015;36:733–42.CrossRefPubMed
4.
Maron BJ, Haas TS, Maron MS, Lesser JR, Browning JA, Chan RH, Olivotto I, Garberich RF, Schwartz RS. Left atrial remodeling in hypertrophic cardiomyopathy and susceptibility markers for atrial fibrillation identified by cardiovascular magnetic resonance. Am J Cardiol. 2014;113:1394–400.CrossRefPubMed
5.
Negishi K, Negishi T, Zardkoohi O, Ching EA, Basu N, Wilkoff BL, Popović ZB, Marwick TH. Left atrial booster pump function is an independent predictor of subsequent life-threatening ventricular arrhythmias in non-ischaemic cardiomyopathy. Eur Heart J Cardiovasc Imaging. 2015;28:jev333.
6.
Imanishi J, Tanaka H, Sawa T, Motoji Y, Miyoshi T, Mochizuki Y, Fukuda Y, Tatsumi K, Matsumoto K, Okita Y, Hirata K. Left atrial booster-pump function as a predictive parameter for new-onset postoperative atrial fibrillation in patients with severe aortic stenosis. Int J Cardiovasc Imaging. 2014;30:295–304.CrossRefPubMed
7.
Kaminski M, Steel K, Jerosch-Herold M, Khin M, Tsang S, Hauser T, Kwong RY. Strong cardiovascular prognostic implication of quantitative left atrial contractile function assessed by cardiac magnetic resonance imaging in patients with chronic hypertension. J Cardiovasc Magn Reson. 2011;13:42–53.CrossRefPubMedPubMedCentral
8.
Kim MN, Lee JJ, Kim SA, Kim YH, Choi JI, Park SM, Park SW, Kim YH, Shim WJ. The difference of predictors for recurrence after catheter ablation of non-paroxysmal atrial fibrillation according to follow-up period. Int Heart J. 2014;55:312–8.CrossRefPubMed
9.
Morris DA, Parwani A, Huemer M, Wutzler A, Bekfani T, Attanasio P, Friedrich K, Kühnle Y, Haverkamp W, Boldt LH. Clinical significance of the assessment of the systolic and diastolic myocardial function of the left atrium in patients with paroxysmal atrial fibrillation and low CHADS (2) index treated with catheter ablation therapy. Am J Cardiol. 2013;111:1002–11.CrossRefPubMed
10.
Kosmala W, Saito M, Kaye G, Negishi K, Linker N, Gammage M, Marwick TH. Protect-Pace Investigators. Incremental value of left atrial structural and functional characteristics for prediction of atrial fibrillation in patients receiving cardiac pacing. Circ Cardiovasc Imaging. 2015;8:e002942. doi:10.​1161/​CIRCIMAGING.​114.​002942.CrossRefPubMed
11.
Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, 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;22:299–305.CrossRefPubMed
12.
Cameli M, Lisi M, Focardi M, Reccia R, Natali BM, Sparla S, Mondillo S. Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes. Am J Cardiol. 2012;110:264–9.CrossRefPubMed
13.
Liu YT, Li RJ, Fang F, Zhang Q, Yan BP, Lam YY, Lee APW, Yu CM. Left atrial function assessed by tissue Doppler imaging as a new predictor of cardiac events after non-ST-elevation acute coronary syndrome. Echocardiography. 2012;29:785–92.CrossRefPubMed
14.
Maceira AM, Prasad SK, Khan M, Pennell DJ. Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2006;8:417–26.CrossRefPubMed
15.
Maceira AM, Prasad SK, Khan M, Pennell DJ. Reference right ventricular systolic and diastolic function normalized to age, gender and body surface area from steady-state free precession cardiovascular magnetic resonance. Eur Heart J. 2006;27:2879–88.CrossRefPubMed
16.
Maceira AM, Cosín-Sales J, Roughton M, Prasad SK, Pennell DJ. Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:65–75.CrossRefPubMedPubMedCentral
17.
Maceira AM, Cosín-Sales J, Roughton M, Prasad SK, Pennell DJ. Reference right atrial dimensions and volume estimation by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2013;8:15–29.
18.
Society BC, Association BH, Society BH, Association BD. Joint British recommendations of prevention of coronary heart disease in clinical practice: summary. Br Medical J. 2000;320:705–8.CrossRef
19.
Blume GG, McLeod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, Tsang TSM. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12:421–30.CrossRefPubMed
20.
Abhayaratna WP, Fatema K, Barnes ME, Seward JB, Gersh BJ, Bailey KR, Casaclang-Verzosa G, Tsang TS. 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;101:1626–9.CrossRefPubMed
21.
Lin FY, Devereux RB, Roman MJ, Meng J, Jow VM, Jacobs A, Weinsaft JW, Shaw LJ, Berman DS, Callister TQ, Min JK. Cardiac chamber volumes, function, and mass as determined by 64-multidetector row computed tomography: mean values among healthy adults free of hypertension and obesity. JACC Cardiovasc Imaging. 2008;1:782–6.CrossRefPubMed
22.
Triposkiadis F, Tentolouris K, Androulakis A, Trikas A, Toutouzas K, Kyriakidis M, Gialafos J, Toutouzas P. 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;8:801–9.CrossRefPubMed
23.
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;13:617–23.CrossRefPubMed
24.
Spencer KT, Mor-Avi V, Gorcsan III J, DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K, Kwan OL, Glascock B, Hancock J, Baumann C, Lang RM. Effects of aging on left atrial reservoir, conduit and booster pump function: a multi-institution acoustic quantification study. Heart. 2001;85:272–7.CrossRefPubMedPubMedCentral
25.
Hesse B, Schuele SU, Thamilasaran M, Thomas J, Rodriguez L. A rapid method to quantify left atrial contractile function: Doppler tissue imaging of the mitral annulus during atrial systole. Eur J Echocardiogr. 2004;5:86–92.CrossRefPubMed
26.
Nagaya M, Kawasaki M, Tanaka R, Onishi N, Sato N, Ono K, Watanabe T, Minatoguchi S, Miwa H, Goto Y, Hirose T, Arai M, Noda T, Watanabe S, Minatoguchi S. Quantitative validation of left atrial structure and function by two-dimensional and three-dimensional speckle tracking echocardiography: A comparative study with three-dimensional computed tomography. J Cardiol. 2013;62:188–94.CrossRefPubMed
27.
Zareian M, Ciuffo L, Habibi M, Opdahl A, Chamera EH, Wu CO, Bluemke DA, Lima JAC, Venkatesh BA. Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment. J Cardiovasc Magn Reson. 2015;17:52.CrossRefPubMedPubMedCentral
28.
Evin M, Cluzel P, Lamy J, Rosenbaum D, Kusmia S, Defrance C, Soulat G, Mousseaux E, Roux C, Clement K, Hatem SN, Redheuil A, Kachenoura N. Assessment of left atrial function by MRI myocardial feature tracking. J Magn Reson Imaging. 2015;42:379–89.CrossRefPubMed
29.
Raman SM, Ng VY, Neff MA, Sayar S, Sparks EA, Nelson SD, Ferketich AK, Wooley CF. Volumetric cine CMR to quantify atrial structure and function in patients with atrial dysrhythmias. J Cardiovasc Magn Reson. 2005;7:539–43.CrossRefPubMed
30.
Hudsmith LE, Petersen SE, Francis JM, Robson MD, Neubauer S. Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. J Cardiovasc Magn Reson. 2005;7:775–82.CrossRefPubMed
31.
Le Ven F, Bibeau K, De Larochelliere E, Tizon-Marcos H, Deneault-Bissonnette S, Pibarot P, Deschepper CF, Larose E. Cardiac morphology and function reference values derived from a large subset of healthy young Caucasian adults by magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2015 Sep 9. pii: jev217. [Epub ahead of print]
32.
Nikitin NP, Witte KKA, Thackray SDR, Goodge LJ, Clark AL, Cleland JGF. Effect of age and sex on left atrial morphology and function. Eur J Ecocardiography. 2003;4:36–42.CrossRef
33.
Morris DA, Takeuchi M, Krisper M, Köhncke C, Bekfani T, Carstensen T, Hassfeld S, Dorenkamp M, Otani K, Takigiku K, Izumi C, Yuda S, Sakata K, Ohte N, Tanabe K, Osmanoglou E, Kühnle Y, Düngen HD, Nakatani S, Otsuji Y, Haverkamp W, Boldt LH. Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study. Eur Heart J Cardiovasc Imaging. 2015;16:364–72.CrossRefPubMed
34.
Schwertz DW, Vizgirda V, Solaro RJ, Piano MR, Ryjewski C. Sexual dimorphism in rat left atrial function and response to adrenergic stimulation. Mol Cell Biochem. 1999;200:143–53.CrossRefPubMed
35.
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 Echocardiography. 2003;4:92–100.CrossRef
36.
Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S, Otsuji Y, Lang RM. Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr. 2009;22:70–5.CrossRefPubMed
37.
Gupta S, Matulevicius SA, Ayers CR, Berry JD, Patel PC, Markham DW, Levine BD, Chin KM, de Lemos JA, Peshock RM, Drazner MH. Left atrial structure and function and clinical outcomes in the general population. Eur Heart J. 2013;34:278–85.CrossRefPubMed
38.
Järvinen VM, Kupari MM, Hekali PE, Poutanen VP. Right atrial MR imaging studies of cadaveric atrial casts and comparison with right and left atrial volumes and function in healthy subjects. Radiology. 1994;191:137–42.CrossRefPubMed
39.
Sievers B, Addo M, Breuckmann F, Barkhausen J, Erbel R. Reference right atrial function determined by steady-state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2007;9:807–14.CrossRefPubMed
40.
Willens HJ, Fertel DP, Qin J, Labrador E, Lowery MH. Effects of age and pulmonary arterial hypertension on the different phases of right atrial function. Int J Cardiovasc Imaging. 2008;24:703–10.CrossRefPubMed
41.
Peluso D, Badano LP, Muraru D, Dal Bianco L, Cucchini U, Kocabay G, Kovács A, Casablanca S, Iliceto S. Right atrial size and function assessed with three-dimensional and speckle-tracking echocardiography in 200 healthy volunteers. Eur Heart J. 2013;14:1106–14.
42.
Aune E, Baekkevar M, Roislien J, Rodevand O, Otterstad JE. Normal reference ranges for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography. Eur J Echocardiogr. 2009;10:738–44.CrossRefPubMed
Metadata
Title
Characterization of left and right atrial function in healthy volunteers by cardiovascular magnetic resonance
Authors
Alicia M. Maceira
Juan Cosin-Sales
Sanjay K. Prasad
Dudley J. Pennell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/s12968-016-0284-8

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