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