Okamatsu Kyoko, Takeuchi Masaaki, Nakai Hiromi, Nishikage Tomoko, Salgo Ivan S, Husson Stephane, Otsuji Yutaka, Lang Roberto M
University of Occupational and Environmental Health, Kitakyushu, Japan.
J Am Soc Echocardiogr. 2009 Jan;22(1):70-5. doi: 10.1016/j.echo.2008.11.006.
Aging affects left atrial (LA) function, which can be assessed by two-dimensional (2D) speckle tracking echocardiography (STE). The aim of this study was to determine (1) the feasibility and accuracy of measuring LA volume with 2DSTE and (2) the effects of aging on LA function.
2DSTE of the LA was acquired from the apical 4-chamber view (frame rate: 63 +/- 11 /sec, iE33) using prototype speckle tracking software (QLAB, Philips Medical Systems, Andover, MA) in 140 healthy volunteers (3-79 years, 74 men). LA wall was tracked on a frame-by-frame basis, and LA volume waveforms were generated. Maximum LA volume (LAVmax) and minimal LA volume (LAVmin), and the LA volume before atrial contraction (LAVpre-a) were measured. Passive emptying percent of total emptying (LA conduit function) and active emptying percent of total emptying (booster function) were calculated as ([LAVmax-LAVpre-a]/[LAVmax-LAVmin]) x 100 and ([LAVa-LAVmin]/[LAVmax-LAVmin]) x 100.
Adequate LA volume waveforms were obtained in all subjects. A good correlation was obtained between speckle tracking-derived LA volume measurements and manually traced LA volume measurements of the identical 2D image (LAVmax: r = 0.93, P <.001, LAVmin: r = 0.88, P <.001, LAVpre-a: r = 0.92, P <.001). Passive and active emptying indices had a significant age dependency (r = 0.80, P <.001). Overall, passive emptying accounted for 67% of the total LA emptying ranging from 83% in the youngest to 42% in the oldest decade.
Aging significantly affects LA conduit and booster function. 2DSTE can effectively and easily measure LA volume and has a potential for the noninvasive assessment of LA function.
衰老会影响左心房(LA)功能,二维(2D)斑点追踪超声心动图(STE)可用于评估该功能。本研究的目的是确定:(1)使用2DSTE测量LA容积的可行性和准确性;(2)衰老对LA功能的影响。
使用原型斑点追踪软件(QLAB,飞利浦医疗系统公司,安多弗,马萨诸塞州),从心尖四腔心切面获取140名健康志愿者(3至79岁,74名男性)的LA的2DSTE图像(帧率:63±11 /秒,iE33)。逐帧追踪LA壁,生成LA容积波形。测量LA最大容积(LAVmax)、最小容积(LAVmin)以及心房收缩前的LA容积(LAVpre-a)。计算总排空的被动排空百分比(LA管道功能)和总排空的主动排空百分比(增强功能),分别为([LAVmax-LAVpre-a]/[LAVmax-LAVmin])×100和([LAVa-LAVmin]/[LAVmax-LAVmin])×100。
所有受试者均获得了足够的LA容积波形。斑点追踪得出的LA容积测量值与同一2D图像手动描绘的LA容积测量值之间具有良好的相关性(LAVmax:r = 0.93,P <.001;LAVmin:r = 0.88,P <.001;LAVpre-a:r = 0.92,P <.001)。被动和主动排空指数与年龄显著相关(r = 0.80,P <.001)。总体而言,被动排空占LA总排空的67%,在最年轻的十年中为83%,在最年长的十年中为42%。
衰老显著影响LA管道和增强功能。2DSTE能够有效且轻松地测量LA容积,具有无创评估LA功能的潜力。