title: Assessment of the developmental change in the left atrial volume using real time three-dimensional echocardiography.
abstract: OBJECTIVE
  Real time 3D echocardiography (RT3DE) has been applied for the assessment of left atrial (LA) function in patients with adult heart disease; however, LA function is not well known in children. We aimed at determining the normal range of LA volume (LAV) using RT3DE and the feasibility and reproducibility of this method in healthy subjects and at elucidating the developmental changes in the LAV with aging.
  
  
  RESULTS
  In this study, 359 healthy people (mean age, 23.9 ± 21.3; range, 0.1-76.4 years) were enrolled. We performed transthoracic RT3DE and measured the maximum and minimum LAV. Simultaneously, we measured the LAV using the 2D biplane Simpson's method. Inter-observer and intra-observer variability and the agreement of LAV measurements between RT3DE and 2DE were assessed in a subset of subjects. The RT3DE feasibility for LAV measurement was 93%. Both maximum and minimum LAVs exponentially increased with age and linearly increased with increasing of body surface area (BSA). The LA distensibility, which demonstrates LA reservoir function, decreased with age and BSA. The LAVs measured by RT3DE were significantly smaller than those measured by the 2D biplane Simpson's method. The 3D volumetric method had favorable intra-observer and inter-observer agreement.
  
  
  CONCLUSIONS
  The reference values of LAV from early infancy to adulthood were obtained using RT3DE, which could be useful for future studies in children with congenital heart disease. RT3DE is a reproducible method and a feasible tool for evaluating the LAV in children. LA reservoir function is likely to decrease with age and increasing of body size.
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.|Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Takigiku
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino, Japan.|Department of Pediatrics, Kyushu Kosei Nenkin Hospital, Kitakyushu, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kuraoka
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Kotoko
authors.initials: K
authors.lastname: Matsui
authors.affiliation: Department of Pediatrics, Hamamatsu University Faculty of Medicine, Hamamatu, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwashima
authors.affiliation: Department of Pediatric Cardiology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nii
authors.affiliation: Department of Pediatrics, Akita University Faculty of Medicine, Akita, Japan.
authors.forename: Manatomo
authors.initials: M
authors.lastname: Toyono
authors.affiliation: Department of the Second Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kishiro
authors.affiliation: Department of Pediatric Cardiology, Nagano Children's Hospital, Azumino, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasukochi
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D015203:Reproducibility of Results; D055815:Young Adult
keywords: LA distensibility; child; real time 3D echocardiography