TY - JOUR
T1 - Left Atrial Size by Planimetry is Superior to M-mode Diameter
T2 - Biochemical Calibration by Atrial and Brain Natriuretic Peptide
AU - Buchner, Stefan
AU - Muscholl, Michael
AU - Debl, Kurt
AU - Hense, Hans Werner
AU - Döring, Angela
AU - Stritzke, Jan
AU - Schunkert, Heribert
AU - Jougasaki, Michihisa
AU - Burnett, John C.
AU - Riegger, Günter A.J.
AU - Luchner, Andreas
N1 - Funding Information:
The MONICA Augsburg studies (monitoring trends and determinants on cardiovascular diseases) were initiated by U. Keil and coworkers and financed by the GSF-National Research Centre for Environment and Health, which is funded by the German Federal Ministry of Education, Science, Research and Technology and by the State of Bavaria. This study was further supported by Deutsche Forschungsgemeinschaft (Lu 562/1-1, 3-1 and Schu 672/9-1, 10-1, 12-1) and Bundesministerium fuer Forschung und Technologie (Kompetenznetz Herzinsuffizienz).
PY - 2008/4
Y1 - 2008/4
N2 - Background: Left atrial (LA) size is routinely assessed by M-mode on echocardiography. Recently, a superiority of apical measures of LA size has been suggested, but no biochemical calibration has been attempted yet. The aim of the current study was to compare echocardiographic parameters of LA size through biochemical calibration with the natriuretic peptides atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). Methods: A total of 610 middle-aged (50-67 years) subjects from a population-based sample (MONICA Augsburg, Germany) were characterized with respect to LA area and volume from the apical two-chamber (2C) and four-chamber (4C) views in addition to M-mode echocardiography. ANP and BNP concentrations were determined by radioimmunoassay. Results: A significant correlation to ANP and BNP was present with all measures on LA size. The univariate correlation was lowest with M-mode diameter (r = 0.11 with ANP; r = 0.09 with BNP, both P < .03), whereas 2C volume displayed the closest correlation (r = 0.20 with ANP and r = 0.28 with BNP, both P < .001) and even slightly exceeded 2C area, 4C volume, and 4C area. 2C volume further displaced LV systolic function, mass index, and heart rate as statistically significant predictors of ANP (P < .001) and BNP (P < .001) on adjusted regression analysis, whereas M-mode diameter was displaced as a significant predictor of ANP and BNP (P = not significant). Conclusions: The current population-based echocardiographic study allows new insight into the value of different measures of LA size. The closer association between natriuretic peptide concentrations and parameters derived from planimetry and volumetry suggests a superiority of these parameters LA diameter. LA volumetry should be included in routine echocardiography for optimized assessment of LA size.
AB - Background: Left atrial (LA) size is routinely assessed by M-mode on echocardiography. Recently, a superiority of apical measures of LA size has been suggested, but no biochemical calibration has been attempted yet. The aim of the current study was to compare echocardiographic parameters of LA size through biochemical calibration with the natriuretic peptides atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). Methods: A total of 610 middle-aged (50-67 years) subjects from a population-based sample (MONICA Augsburg, Germany) were characterized with respect to LA area and volume from the apical two-chamber (2C) and four-chamber (4C) views in addition to M-mode echocardiography. ANP and BNP concentrations were determined by radioimmunoassay. Results: A significant correlation to ANP and BNP was present with all measures on LA size. The univariate correlation was lowest with M-mode diameter (r = 0.11 with ANP; r = 0.09 with BNP, both P < .03), whereas 2C volume displayed the closest correlation (r = 0.20 with ANP and r = 0.28 with BNP, both P < .001) and even slightly exceeded 2C area, 4C volume, and 4C area. 2C volume further displaced LV systolic function, mass index, and heart rate as statistically significant predictors of ANP (P < .001) and BNP (P < .001) on adjusted regression analysis, whereas M-mode diameter was displaced as a significant predictor of ANP and BNP (P = not significant). Conclusions: The current population-based echocardiographic study allows new insight into the value of different measures of LA size. The closer association between natriuretic peptide concentrations and parameters derived from planimetry and volumetry suggests a superiority of these parameters LA diameter. LA volumetry should be included in routine echocardiography for optimized assessment of LA size.
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U2 - 10.1016/j.echo.2007.06.006
DO - 10.1016/j.echo.2007.06.006
M3 - Article
C2 - 17681726
AN - SCOPUS:41449107453
SN - 0894-7317
VL - 21
SP - 380
EP - 385
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 4
ER -