RIGHT ATRIAL STRAIN IN A NORMAL ADULT AFRICAN POPULATION AND ITS
CORRELATION WITH AGE
Mushitu Nyange1, Ruchika Meel2
Affiliations:
Department of Internal medicine, Faculty of Health Sciences,
University of the Witwatersrand.
Department of Internal medicine, Division of Cardiology, Chris Hani
Baragwanath Academic Hospital, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South Africa
Corresponding Author:
Nyange Mushitu
E-mail: nyangemush@gmail.com
Contact details: cell: 0729844592
Running head : Right atrial Strain in African population.
Authors’ contributions:
Mushitu Nyange : collection of data, data analysis/interpretation,
drafting article and approved manuscript.
Ruchika Meel : conceptualised, designed study, data
analysis/interpretation, drafting article, critical revision of article,
approved manuscript.
Disclosure: No conflicts of interest.
Introduction
In the last twenty years, there has been great interest in RA function
research, because recent data have demonstrated that, assessment of RA
volumetric parameters on echocardiography is an essential predictor of
morbidity and mortality in various cardiovascular
disorders.(1–3)
There are several imaging studies that have described RA anatomy and
function. The RA dimensions, volume, and strain have been studied using
cardiac magnetic resonance (CMR) the gold standard, computed tomography,
echocardiography (two dimensional and three dimensional) and recently
speckle tracking echocardiography (STE). The two-dimensional
echocardiography (2DE) has become the most clinically relevant
non-invasive technique evaluating the RA.(4–6)
It is important to define normative values of RA strain using 2DE,
because RA subclinical dysfunction as measured by strain has been
observed in several cardiovascular disorders prior to changes in the
traditional indices of RA and RV function such as volume, sizes and
ejection fraction. Such cardiovascular disorders include pulmonary
arterial hypertension (PAH), coronary artery disease (CAD), and heart
failure with reduced ejection fraction (HFrEF). RA strain had additive
prognostic value to other clinical measures, including RV strain, RA
area, and RA pressure, in patients with PAH.(7–11)The
difference between normal and abnormal RA dimensions and function is
therefore clinically pertinent.
Most of the available studies on RA dimensions parameters in a normal
population are depend on data from North America and Europe and are in
line with the guidelines of the American Society of Echocardiography
(ASE) and European Society of Cardiology
(ESC)..(12–15)These values do not effectively
represent the diverse racial and ethnic groups of the world.
Study by Soulat-Dufour et al, with the World Alliance Societies of
Echocardiography (WASE) have suggested that there might be significant
differences in normal values among different populations.(16)Currently, limited data exist regarding RA volume
(RAV), size and strain in a normal black adult African population.
Age-related changes in vascular and cardiac function contribute to
cardiovascular mortality. Aging is associated with abnormalities in
left-sided functional parameters. However, studies on age-related
changes in right-sided functional parameters are
scarce.(17–19)
Thus, in this study, we sought to establish normal values for RAV and RA
longitudinal strain (RALS); and its correlation with age, in a
Sub-Saharan black African population, using the 2DE and STE .
Methods