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. 2001 Mar;85(3):272–277. doi: 10.1136/heart.85.3.272

Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study

K Spencer 1, V Mor-Avi 1, J Gorcsan 1, A DeMaria 1, T Kimball 1, M Monaghan 1, J Perez 1, L Weinert 1, J Bednarz 1, K Edelman 1, O Kwan 1, B Glascock 1, J Hancock 1, C Baumann 1, R Lang 1
PMCID: PMC1729654  PMID: 11179264

Abstract

OBJECTIVE—To assess the feasibility of measuring left atrial (LA) function with acoustic quantification (AQ) and then assess the effects of age and sex on LA reservoir, conduit, and booster pump function.
PATIENTS AND SETTING—165 subjects without cardiovascular disease, 3-79 years old, were enrolled by six tertiary hospital centres.
INTERVENTIONS—Continuous LA AQ area data were acquired and signal averaged to form composite waveforms which were analysed off-line.
MAIN OUTCOME MEASURES—Parameters of LA performance according to age and sex.
RESULTS—Signal averaged LA waveforms were sufficiently stable and detailed to allow automated analysis in all cases. An age related increase in LA area was noted. LA reservoir function did not vary with age or sex. All parameters of LA passive and active emptying revealed a significant age dependency. Overall, the passive emptying phase accounted for 66% of total LA emptying ranging from 76% in the youngest to 44% in the oldest decade. LA contraction accounted for 34% of atrial emptying in all subjects combined with the older subjects being more dependent on atrial booster pump function. When adjusted for atrial size, there were no sex related differences in LA function.
CONCLUSIONS—LA reservoir, conduit, and booster pump function can be assessed with automated analysis of signal averaged LA area waveforms. As LA performance varies with age, establishment of normal values should enhance the evaluation of pathologic states in which LA function is important.


Keywords: aging; atrium; echocardiography

Full Text

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Figure 1  .

Figure 1  

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Apical four chamber view with acoustic quantification activated and optimised for the left atrium. The bottom of the figure shows the LA AQ area waveform (green).

Figure 2  .

Figure 2  

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Signal averaged AQ LA area (top) and LA derivative (middle) waveforms. Left ventricular (LV) volume waveforms (bottom) are shown for reference. The phases of the cardiac cycle are labelled: R, reservoir; C, conduit; B, booster pump; LAmin, minimum area; LAmax, maximum area; LAoae, onset atrial emptying area; PFR, peak filling rate; PPER, peak passive emptying rate; PAER, peak active emptying rate.

Figure 3  .

Figure 3  

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Composite LA waveforms generated by time normalising and averaging 10 subjects from each decade. There is an obvious morphologic change in the LA area and derivative waveform from the third to the eighth decade of life. Note the progressive decline in passive emptying and augmented active atrial booster pump function with age.

Figure 4  .

Figure 4  

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Age related changes in the passive and active contributions to total LA emptying in normal subjects.

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