Atrial strain rate is a sensitive measure of alterations in atrial phasic function in healthy ageing

• Published in: Heart (British Cardiac Society) Vol. 97; no. 18; pp. 1513 - 1519
• Main Authors: Boyd, Anita C, Richards, David A B, Marwick, Thomas, Thomas, Liza
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.09.2011; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Age; Aged; Aged, 80 and over; Ageing; Aging; Aging - physiology; Atrial Function; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Echocardiography; Echocardiography, Doppler, Color; Ethnicity; Family medical history; Female; Flow velocity; Heart; Heart Atria - diagnostic imaging; Heart Ventricles - diagnostic imaging; Humans; Hypertension; left atrium; Male; Medical sciences; Middle Aged; Observer Variation; Physiology; strain; Studies; Veins & arteries; Ventricular Function - physiology; Alteration; Circulatory system; Cardiology; Rate; Ageing; Strain
• ISSN: 1355-6037; 1468-201X; 1468-201X
• DOI: 10.1136/heartjnl-2011-300134

ObjectiveStrain and strain rate measure local deformation of the myocardium and have been used to evaluate phasic atrial function in various disease states. The aim of this study was to define normal values for tissue Doppler-derived atrial strain measurements and examine age-related changes by decade in healthy individuals.MethodsTransthoracic echocardiograms were performed on 188 healthy subjects. Tissue Doppler-derived strain and strain rate were measured from the apical four and two-chamber views of the left atrium, and global values were calculated as the mean of all segments. Measurements included peak systolic strain, systolic strain rate, early and late diastolic strain rate. Phasic left atrial volumes and fractions were calculated. Mitral inflow and tissue Doppler imaging were employed to estimate left ventricular diastolic function.ResultsA significant reduction in global systolic strain was observed from decade 6. Alterations in atrial strain rate were apparent from decade 5; systolic strain rate and early diastolic strain rate decreased, while late diastolic strain rate increased significantly. Changes in phasic atrial volume and function occurred in conjunction with age-related changes in left ventricular diastolic function. Importantly, age-related changes in global atrial systolic strain rate and early diastolic strain rate occurred a decade before corresponding changes in atrial phasic volume parameters.ConclusionAtrial strain and strain rate can be used to quantify atrial phasic function and appear to be altered before traditional parameters with ageing. Strain analysis may therefore be more sensitive in detecting subclinical atrial dysfunction with alterations in strain rate parameters observed before traditional parameters.