Badano Luigi P, Miglioranza Marcelo H, Mihăilă Sorina, Peluso Diletta, Xhaxho Jola, Marra Martina Perazzolo, Cucchini Umberto, Soriani Nicola, Iliceto Sabino, Muraru Denisa
From the Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy (L.P.B., D.P., J.X, M.P.M., U.C., N.S., S.I., D.M.); Cardiology Institute of Rio Grande do Sul, Porto Alegre, Brazil (M.H.M.); and Carol Davila University of Medicine and Pharmacy, Emergency University Hospital, Bucharest, Romania (S.M.).
Circ Cardiovasc Imaging. 2016 Jul;9(7). doi: 10.1161/CIRCIMAGING.115.004229.
Our study sought to (1) identify reference values for left atrial (LA) volumes and phasic function indices by 3-dimensional echocardiography (3DE) and compare them with those measured by 2-dimensional echocardiography (2DE) and (2) analyze their relationship with age, sex, body size, and left ventricular function. Accuracy and reproducibility of 3DE and 2DE have been also tested to evaluate the robustness of our data.
We obtained maximal, minimal, and preA LA volumes by 3DE and 2DE in 276 healthy volunteers (18-79 years; 57% women). Limits of normality for LA volumes and total LA emptying fraction were larger with 3DE than with 2DE (maximal LA volume: 43 versus 35 mL/m(2); preA LA volume: 31 versus 25 mL/m(2); minimal LA volume: 18 versus 14 mL/m(2); 53 versus 48%, respectively; P<0.001). 3DE LA volumes indexed by body surface area were similar in men and women and increased with age. On multivariable analysis, age, weight, and left ventricular systolic and diastolic function indices resulted as correlates of LA 3DE indices. LA volumes were tightly correlated with cardiac magnetic resonance measurements, yet more underestimated by 2DE versus 3DE (bias±SD: -17±16 versus -7±15 mL, respectively). Among all LA parameters, maximal LA volume and total emptying fraction were the most reproducible, including at test-retest and at expert versus trainee comparisons.
This study provides reference values for LA 3DE volumes and function from a relatively large cohort of healthy subjects with a wide age range. Our data may help clinicians to identify LA remodeling and dysfunction.
我们的研究旨在（1）通过三维超声心动图（3DE）确定左心房（LA）容积和相位功能指标的参考值，并将其与二维超声心动图（2DE）测量的值进行比较，以及（2）分析它们与年龄、性别、体型和左心室功能的关系。还测试了3DE和2DE的准确性和可重复性，以评估我们数据的稳健性。
我们通过3DE和2DE在276名健康志愿者（18 - 79岁；57%为女性）中获得了LA的最大、最小和预A容积。3DE测量的LA容积和总LA排空分数的正常范围比2DE测量的更大（最大LA容积：43对35 mL/m²；预A LA容积：31对25 mL/m²；最小LA容积：18对14 mL/m²；分别为53%对48%；P<0.0)。按体表面积指数化的3DE LA容积在男性和女性中相似，并随年龄增加。在多变量分析中，年龄、体重以及左心室收缩和舒张功能指标是LA 3DE指标的相关因素。LA容积与心脏磁共振测量结果密切相关，但2DE比3DE更易低估（偏差±标准差：分别为-17±16对-7±15 mL）。在所有LA参数中，最大LA容积和总排空分数的可重复性最高，包括在重测以及专家与实习生比较时。
本研究为来自年龄范围广泛的相对大量健康受试者队列提供了LA 3DE容积和功能的参考值。我们的数据可能有助于临床医生识别LA重塑和功能障碍。
