Normal Values of Right Atrial Size and Function According to Age, Sex, and Ethnicity: Results of the World Alliance Societies of Echocardiography Study.

Adolescent Adult Aged Atrial Function, Right Cross-Sectional Studies Echocardiography Echocardiography, Three-Dimensional Ethnicity Female Heart Atria / diagnostic imaging Humans Male Prospective Studies Reference Values Young Adult

Normal values Right atrial strain Right atrial volume Right atrium

Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

ISSN: 1097-6795

Titre abrégé: J Am Soc Echocardiogr

Pays: United States

ID NLM: 8801388

Informations de publication

Date de publication:
03 2021

Historique:

received: 23 09 2020

revised: 20 10 2020

accepted: 10 11 2020

pubmed: 20 11 2020

medline: 25 9 2021

entrez: 19 11 2020

Statut: ppublish

Résumé

The World Alliance Societies of Echocardiography study is a multicenter, international, prospective, cross-sectional study whose aims were to evaluate healthy adult individuals to establish age- and sex-normative values of echocardiographic parameters and to determine whether differences exist among people from different countries and of different ethnicities. The present report focuses on two-dimensional (2D) and three-dimensional (3D) right atrial (RA) size and function. Transthoracic 2D and 3D echocardiographic images were obtained in 2,008 healthy adult individuals evenly distributed among subgroups according to sex (1,033 men, 975 women) and age 18 to 40 years (n = 854), 41 to 65 years (n = 653), and >65 years (n = 501). For ethnicity, 34.9% were white, 41.6% Asian, and 9.7% black. Images were analyzed in a core laboratory according to current American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. RA measurements included 2D dimensions, 2D and 3D RA volumes (RAVs) indexed to body surface area (BSA), emptying fraction (EmF), and global longitudinal strain, including total/reservoir, passive/conduit, and active/contractile phases. Differences among age and sex categories and among countries were also examined. RAVs were larger in men (even after BSA indexing), while 3D total EmF and global longitudinal strain magnitudes were higher in women. For both sexes, there were no significant age-related differences in 2D RAV measurements, but 3D RAV values differed minimally with age, remaining significant after BSA indexing. RA total EmF and reservoir strain and passive EmF and conduit strain magnitude were lower in older groups for both sexes. Interestingly, whereas RA active EmF increased with age, contractile strain magnitude decreased. Considerable geographic variations were identified: Asians of both sexes had significantly lower BSA than non-Asians, and their 2D and 3D end-systolic RAVs were significantly smaller even after BSA indexing. Of note, 2D end-systolic RAVs in this group were considerably lower than normal values provided in the current guidelines. There is significant sex, age, and geographic variability in normal RA size and function parameters. Current guideline-recommended normal ranges for RA size and function parameters should be adjusted geographically on the basis of the results of this study.

Sections du résumé

BACKGROUND

METHODS

Transthoracic 2D and 3D echocardiographic images were obtained in 2,008 healthy adult individuals evenly distributed among subgroups according to sex (1,033 men, 975 women) and age 18 to 40 years (n = 854), 41 to 65 years (n = 653), and >65 years (n = 501). For ethnicity, 34.9% were white, 41.6% Asian, and 9.7% black. Images were analyzed in a core laboratory according to current American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. RA measurements included 2D dimensions, 2D and 3D RA volumes (RAVs) indexed to body surface area (BSA), emptying fraction (EmF), and global longitudinal strain, including total/reservoir, passive/conduit, and active/contractile phases. Differences among age and sex categories and among countries were also examined.

RESULTS

RAVs were larger in men (even after BSA indexing), while 3D total EmF and global longitudinal strain magnitudes were higher in women. For both sexes, there were no significant age-related differences in 2D RAV measurements, but 3D RAV values differed minimally with age, remaining significant after BSA indexing. RA total EmF and reservoir strain and passive EmF and conduit strain magnitude were lower in older groups for both sexes. Interestingly, whereas RA active EmF increased with age, contractile strain magnitude decreased. Considerable geographic variations were identified: Asians of both sexes had significantly lower BSA than non-Asians, and their 2D and 3D end-systolic RAVs were significantly smaller even after BSA indexing. Of note, 2D end-systolic RAVs in this group were considerably lower than normal values provided in the current guidelines.

CONCLUSIONS

There is significant sex, age, and geographic variability in normal RA size and function parameters. Current guideline-recommended normal ranges for RA size and function parameters should be adjusted geographically on the basis of the results of this study.

Identifiants

DOI: 10.1016/j.echo.2020.11.004 PMID: 33212183

pubmed: 33212183

pii: S0894-7317(20)30722-7

doi: 10.1016/j.echo.2020.11.004

pii:

doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

286-300

Investigateurs

Aldo D Prad (AD)

Agatha Kwon (A)

Samantha Hoschke-Edwards (S)

Tania Regina Afonso (TR)

Babitha Thampinathan (B)

Maala Sooriyakanthan (M)

Tiangang Zhu (T)

Zhilong Wang (Z)

R Alagesan (R)

Azin Alizadehasl (A)

Luigi Badano (L)

Tomoko Nakao (T)

Takayuki Kawata (T)

Megumi Hirokawa (M)

Naoko Sawada (N)

Hye Rim Yun (HR)

Ji-Won Hwang (JW)