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  • Title: Determinants of echocardiographic left atrial volume: implications for normalcy.
    Author: Nistri S, Galderisi M, Ballo P, Olivotto I, D'Andrea A, Pagliani L, Santoro A, Papesso B, Innelli P, Cecchi F, Mondillo S, Working Group on Echocardiography of the Italian Society of Cardiology.
    Journal: Eur J Echocardiogr; 2011 Nov; 12(11):826-33. PubMed ID: 21880608.
    Abstract:
    AIMS: The relative role of multiple determinants of left atrial volume index (LAVi) in athletes and non-athletes is not fully defined. Thus, we decided to prospectively assess the determinants of LAVi in healthy individuals and competitive athletes over a wide age range. METHODS AND RESULTS: Four hundred and eighteen healthy individuals (mean age 41.7 ± 15.6 years, range 16-84, 65% males, 38% competitive athletes) underwent Doppler echocardiography including assessment of LAVi by the biplane area-length method and of left ventricular (LV) diastolic function including the ratio of early diastolic peak LV inflow velocity to peak myocardial early diastolic velocity (E/e'). Mean LAVi was 32.2 ± 9.0 mL/m(2) in the pooled population. LAVi was larger in athletes than in non-athletes (38.9 ± 9.6 mL/m(2) vs. 28.4 ± 5.8 mL/m(2), P < 0.0001). In the pooled population a stepwise multiple linear regression analysis identified LV end-diastolic volume index (LVEDVi) (β = 0.378, P < 0.0001), LV mass index (LVMi) (β = 0.260, P < 0.0001), competitive sport activity (β = 0.258, P < 0.0001), and age (β = 0.222, P < 0.0001) as independent determinants of LAVi (model R(2) = 0.54, P < 0.0001). By separate analyses, although LVEDVi, age, and LVMi were predictors of LAVi in both groups, body mass index and the E/e' ratio were additional predictors of LAVi only in non-athletes. CONCLUSIONS: In healthy individuals LV size, competitive sport, age, and LV mass are independent determinants of LAVi. Body mass index and the E/e' ratio affect LAVi only in non-athletes. These findings may have practical implications when assessing normalcy of LA size in the clinical setting.
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