Left Atrial Structure in Relationship to Age, Sex, Ethnicity, and Cardiovascular Risk Factors

Filip Zemrak, Bharath Ambale Venkatesh, Gabriella Captur, Jonathan Chrispin, Ela Chamera, Mohammadali Habibi, Saman Nazarian, Saidi A. Mohiddin, James C. Moon, Steffen E. Petersen, Joao Lima, David A. Bluemke

Research output: Contribution to journalArticle

Abstract

Background - Left atrial (LA) size is a marker of diastolic function and is associated with atrial fibrillation and cardiovascular outcomes. However, there are no large population studies measuring LA structure. The relationship of demographics and cardiovascular risk factors to LA size is largely unknown. This study aimed to determine associations of LA size with demographic factors, cardiac structure and function, and cardiovascular risk factors. Methods and Results - LA volume indexed to body surface area was measured by cardiovascular magnetic resonance steady-state free precession and fast gradient echo cine long- and short-axis images in 2576 asymptomatic participants of MESA ([Multi-Ethnic Study of Atherosclerosis] 68.7 years, 53.0% women, white 42.2%, Chinese American 12.0%, black 24.5%, and Hispanic 21.2%) using biplane and short-axis images. The mean LA volume index was 36.5±11.4 mL/m 2 in the entire cohort and 35.5±10.1 mL/m 2 in subjects free of cardiovascular risk factors (n=283). Multivariable analysis included adjustment for demographics, ethnicity, cardiovascular risk factors, serological studies, socioeconomic status, left ventricular structure, and medications. In the adjusted analysis, age (β=0.2 mL/m 2 per year, P<0.0001), male sex (β=-4.2 mL/m 2, P<0.0001), obesity (β=1.3 mL/m 2, P<0.01), end-diastolic volume index (β=0.4 mL/m 2, P<0.0001), Chinese American (β=-2.6 mL/m 2, P<0.0001), and Hispanic (β=1.1 mL/m 2, P<0.05) ethnicities were associated with LA volume index. Diabetes mellitus and smoking were not associated with LA volume index. LA volumes measured by steady-state free precession were 3% larger than by fast gradient echo cine cardiovascular magnetic resonance (P<0.001). Conclusions - Age, sex, ethnicity and left ventricular structural parameters were associated with LA size. Importantly, the study provides reference values of normal LA volume index.

Original languageEnglish (US)
Article numbere005379
JournalCirculation: Cardiovascular Imaging
Volume10
Issue number2
DOIs
StatePublished - Feb 1 2017

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Asian Americans
Demography
Hispanic Americans
Magnetic Resonance Spectroscopy
Body Surface Area
Social Class
Atrial Fibrillation
Atherosclerosis
Diabetes Mellitus
Reference Values
Obesity
Smoking
Population

Keywords

  • body surface area
  • magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Left Atrial Structure in Relationship to Age, Sex, Ethnicity, and Cardiovascular Risk Factors. / Zemrak, Filip; Ambale Venkatesh, Bharath; Captur, Gabriella; Chrispin, Jonathan; Chamera, Ela; Habibi, Mohammadali; Nazarian, Saman; Mohiddin, Saidi A.; Moon, James C.; Petersen, Steffen E.; Lima, Joao; Bluemke, David A.

In: Circulation: Cardiovascular Imaging, Vol. 10, No. 2, e005379, 01.02.2017.

Research output: Contribution to journalArticle

Zemrak, F, Ambale Venkatesh, B, Captur, G, Chrispin, J, Chamera, E, Habibi, M, Nazarian, S, Mohiddin, SA, Moon, JC, Petersen, SE, Lima, J & Bluemke, DA 2017, 'Left Atrial Structure in Relationship to Age, Sex, Ethnicity, and Cardiovascular Risk Factors', Circulation: Cardiovascular Imaging, vol. 10, no. 2, e005379. https://doi.org/10.1161/CIRCIMAGING.116.005379
Zemrak, Filip ; Ambale Venkatesh, Bharath ; Captur, Gabriella ; Chrispin, Jonathan ; Chamera, Ela ; Habibi, Mohammadali ; Nazarian, Saman ; Mohiddin, Saidi A. ; Moon, James C. ; Petersen, Steffen E. ; Lima, Joao ; Bluemke, David A. / Left Atrial Structure in Relationship to Age, Sex, Ethnicity, and Cardiovascular Risk Factors. In: Circulation: Cardiovascular Imaging. 2017 ; Vol. 10, No. 2.
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AU - Zemrak, Filip

AU - Ambale Venkatesh, Bharath

AU - Captur, Gabriella

AU - Chrispin, Jonathan

AU - Chamera, Ela

AU - Habibi, Mohammadali

AU - Nazarian, Saman

AU - Mohiddin, Saidi A.

AU - Moon, James C.

AU - Petersen, Steffen E.

AU - Lima, Joao

AU - Bluemke, David A.

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N2 - Background - Left atrial (LA) size is a marker of diastolic function and is associated with atrial fibrillation and cardiovascular outcomes. However, there are no large population studies measuring LA structure. The relationship of demographics and cardiovascular risk factors to LA size is largely unknown. This study aimed to determine associations of LA size with demographic factors, cardiac structure and function, and cardiovascular risk factors. Methods and Results - LA volume indexed to body surface area was measured by cardiovascular magnetic resonance steady-state free precession and fast gradient echo cine long- and short-axis images in 2576 asymptomatic participants of MESA ([Multi-Ethnic Study of Atherosclerosis] 68.7 years, 53.0% women, white 42.2%, Chinese American 12.0%, black 24.5%, and Hispanic 21.2%) using biplane and short-axis images. The mean LA volume index was 36.5±11.4 mL/m 2 in the entire cohort and 35.5±10.1 mL/m 2 in subjects free of cardiovascular risk factors (n=283). Multivariable analysis included adjustment for demographics, ethnicity, cardiovascular risk factors, serological studies, socioeconomic status, left ventricular structure, and medications. In the adjusted analysis, age (β=0.2 mL/m 2 per year, P<0.0001), male sex (β=-4.2 mL/m 2, P<0.0001), obesity (β=1.3 mL/m 2, P<0.01), end-diastolic volume index (β=0.4 mL/m 2, P<0.0001), Chinese American (β=-2.6 mL/m 2, P<0.0001), and Hispanic (β=1.1 mL/m 2, P<0.05) ethnicities were associated with LA volume index. Diabetes mellitus and smoking were not associated with LA volume index. LA volumes measured by steady-state free precession were 3% larger than by fast gradient echo cine cardiovascular magnetic resonance (P<0.001). Conclusions - Age, sex, ethnicity and left ventricular structural parameters were associated with LA size. Importantly, the study provides reference values of normal LA volume index.

AB - Background - Left atrial (LA) size is a marker of diastolic function and is associated with atrial fibrillation and cardiovascular outcomes. However, there are no large population studies measuring LA structure. The relationship of demographics and cardiovascular risk factors to LA size is largely unknown. This study aimed to determine associations of LA size with demographic factors, cardiac structure and function, and cardiovascular risk factors. Methods and Results - LA volume indexed to body surface area was measured by cardiovascular magnetic resonance steady-state free precession and fast gradient echo cine long- and short-axis images in 2576 asymptomatic participants of MESA ([Multi-Ethnic Study of Atherosclerosis] 68.7 years, 53.0% women, white 42.2%, Chinese American 12.0%, black 24.5%, and Hispanic 21.2%) using biplane and short-axis images. The mean LA volume index was 36.5±11.4 mL/m 2 in the entire cohort and 35.5±10.1 mL/m 2 in subjects free of cardiovascular risk factors (n=283). Multivariable analysis included adjustment for demographics, ethnicity, cardiovascular risk factors, serological studies, socioeconomic status, left ventricular structure, and medications. In the adjusted analysis, age (β=0.2 mL/m 2 per year, P<0.0001), male sex (β=-4.2 mL/m 2, P<0.0001), obesity (β=1.3 mL/m 2, P<0.01), end-diastolic volume index (β=0.4 mL/m 2, P<0.0001), Chinese American (β=-2.6 mL/m 2, P<0.0001), and Hispanic (β=1.1 mL/m 2, P<0.05) ethnicities were associated with LA volume index. Diabetes mellitus and smoking were not associated with LA volume index. LA volumes measured by steady-state free precession were 3% larger than by fast gradient echo cine cardiovascular magnetic resonance (P<0.001). Conclusions - Age, sex, ethnicity and left ventricular structural parameters were associated with LA size. Importantly, the study provides reference values of normal LA volume index.

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