Page 56 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

ABSTRACT
Ageing is associated with changes in left atrial (LA) structure and function. The present study aimed at describing the effect of ageing on LA properties in a large cohort of individuals without structural heart disease. We divided 386 individuals (mean age 58 (range 16-91) years; 188 (49%) males) clinically referred for echocardiography according to age groups. The P-wave dispersion (PWD), reflecting total atrial conduction time, was measured on a 12-lead surface electrocardiogram (ECG) as the difference between maximum and minimum P-wave duration. The PA-TDI duration reflecting the total atrial conduction time was measured on tissue Doppler imaging (TDI) as the time between onset of P-wave on surface ECG to peak A’-wave velocity. Two-dimensional speckle tracking echocardiography was used to assess LA reservoir function, reflecting LA compliance. In the overall population mean PWD, PA-TDI and LA reservoir strain were 43±12 ms, 129±27 ms and 36±13%, respectively. Increasing age was independently associated with prolonged PWD (β=0.161; p<0.001), PA- TDI (β=0.476; p<0.001) and reduced LA reservoir strain (β= -0.259; <0.001), suggesting age-related fibrotic changes of the LA myocardium. The association between age and LA reservoir strain was modulated by body mass index (β=- 0.582; p<0.001) and LA volume index (β=-0.117; p=0.014). In conclusion, ageing is associated with longer PWD and PA-TDI duration along with a decrease in LA reservoir function. Obesity and larger LA volumes are independently associated with reduced LA compliance.