title: Left atrial volume and geometry in healthy aging: the Cardiovascular Health Study.
abstract: BACKGROUND
  The left atrium is a validated marker of clinical and subclinical cardiovascular disease. Left atrial enlargement is often seen among older individuals; however, there are few population-based data regarding normal left atrial size among older persons, especially from those who are healthy, and from women. Furthermore, because the left atrium is a 3D structure, the commonly used parasternal long-axis diastolic diameter often underdiagnoses left atrial enlargement.
  
  
  RESULTS
  We evaluated left atrial size in 230 healthy participants (mean age, 76+/-5 years) free of prevalent cardiac disease, rhythm abnormality, hypertension, and diabetes selected from the Cardiovascular Health Study, a prospective community-based study of risk factors for cardiovascular disease in 5888 elderly participants. In addition to the standard long-axis measurement, we obtained left atrial superoinferior and lateral diameters and used these dimensions to estimate left atrial volume. These measurements were used to generate reference ranges for determining left atrial enlargement in older men and women, based on the 95% percentiles of the left atrial dimensions in healthy participants, both unadjusted, and after adjustment for age, height, and weight. In healthy elderly subjects, indices of left atrial size do not correlate with age or height but with weight and other measures of body build.
  
  
  CONCLUSIONS
  These data provide normative reference values for left atrial size in healthy older women and men. The results should be useful for refining diagnostic criteria for left atrial dilation in the older population and may be relevant for cardiovascular risk stratification.
authors.affiliation: University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA. gerard.aurigemma@umassmed.edu
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.forename: Marcello
authors.initials: M
authors.lastname: Chinali
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Hill
authors.forename: Dalane
authors.initials: D
authors.lastname: Kitzman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016279:Atrial Function, Left; D049628:Body Size; D001830:Body Surface Area; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D016014:Linear Models; D008297:Male; D008954:Models, Biological; D009929:Organ Size; D011159:Population Surveillance; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors; D014481:United States