Effect of age and sex on left atrial morphology and function

Aims: Left atrial function is abnormal in a wide range of cardiac diseases. This study was designed to assess the effects of normal ageing and sex on left atrial morphology and function.

Methods and results: Echocardiography was performed in 123 subjects (age 57 +/- 19 years, range 22 to 89 years, 59 women) with no evidence of cardiovascular disease. M-mode derived left atrial size, B-mode derived left atrial maximal and minimal volumes, and the volume at onset of atrial systole (P-volume) were measured. Left atrial filling, active and passive emptying volumes and ejections fractions, and expansion index were calculated. Subjects were divided into four groups according to age. Left atrial diameter increased with age, with significantly smaller left atrial size in younger subjects. The oldest subjects had significantly higher (P<0.05) left atrial minimal, maximal and P-volume indices. Filling volume index was highest in the oldest subjects (21.9 +/- 5.6 ml/m(2)). Passive emptying volume index was the lowest in those of middle age (10.5 +/- 2.8 ml/m(2)). Active emptying volume index progressively increased with age (P<0.001). Left atrial expansion index and active emptying fraction were not different between the age groups. There was significant difference in passive emptying fraction (P<0.001) with highest values in the youngest (44.7 +/- 7.3%) and lowest values in the oldest subjects (33.6+/-5.4%).

Conclusions: Age- and sex-related reference values of echocardiographic indices of left atrial morphology and function are reported. Ageing is associated with left atrial dilatation. Left atrial conduit function deteriorates with age while reservoir and pump function are maintained. Left atrial anteroposterior diameter is smaller in women than in men, but overall left atrial function is not influenced by sex.