Nielsen Anne Bjerg, Skaarup Kristoffer Grundtvig, Hauser Raphael, Johansen Niklas Dyrby, Lassen Mats Christian Højbjerg, Jensen Gorm Boje, Schnohr Peter, Møgelvang Rasmus, Biering-Sørensen Tor
Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Gentofte Hospitalsvej 1, DK-2900 Copenhagen, Denmark.
The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
Eur Heart J Cardiovasc Imaging. 2021 Dec 18;23(1):42-51. doi: 10.1093/ehjci/jeab201.
Left atrial (LA) function assessed by two-dimensional speckle-tracking echocardiography has shown increasing clinical and prognostic significance. We sought to establish age- and sex-based normative values of LA strain in the general population and to assess the prognostic yield of lower limits of normality of LA strain in relation to future atrial fibrillation (AF).
We determined normative values of peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and LA strain during the conduit phase (LACS) in 1641 healthy participants included in the fifth Copenhagen City Heart Study. In a secondary analysis, a validation cohort of 2016 participants, regardless of health status, were included to assess the prognostic value of the established reference values. In the healthy cohort, median age was 46 years (interquartile range 32-57), 62% were female. Median PALS, PACS, and LACS and corresponding limits of normality in the healthy participants were 39.4% (23.0-67.6%), 15.5% (6.4-28.0%), and 23.7% (8.8-44.8%), respectively. There was a tendency of lower values of PALS and LACS in males and older participants, while PACS tended to increase with advancing age. The established lower limits of normality showed high specificity (range 93-94%) regarding future AF, implying a low risk of developing AF in participants with LA strain above the lower limits of normality in their respective sex and age group.
We report normal values for LA strain stratified by sex and age. The lower limits of normality showed high specificity regarding future AF.
二维斑点追踪超声心动图评估的左心房（LA）功能已显示出越来越大的临床和预后意义。我们试图建立一般人群中基于年龄和性别的LA应变正常参考值，并评估LA应变正常下限与未来房颤（AF）相关的预后价值。
我们在哥本哈根市第五次心脏研究纳入的1641名健康参与者中确定了心房纵向峰值应变（PALS）、心房收缩峰值应变（PACS）和管道期LA应变（LACS）的正常参考值。在一项二次分析中，纳入了2016名参与者的验证队列，无论其健康状况如何，以评估所建立参考值的预后价值。在健康队列中，中位年龄为46岁（四分位间距32 - 57岁），62%为女性。健康参与者的中位PALS、PACS和LACS以及相应的正常下限分别为39.4%（23.0 - 67.6%）、15.5%（6.4 - 28.0%）和23.7%（8.8 - 44.8%）。男性和老年参与者的PALS和LACS值有降低的趋势，而PACS则随年龄增长有升高趋势。所建立的正常下限对未来AF显示出高特异性（范围93 - 94%），这意味着LA应变高于其各自性别和年龄组正常下限的参与者发生AF的风险较低。
我们报告了按性别和年龄分层的LA应变正常值。正常下限对未来AF显示出高特异性。
