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Standardised computed tomographic assessment of left atrial morphology and tissue thickness in humans

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number100694
JournalIJC Heart & Vasculature
Volume32
Early online date24 Dec 2020
DOIs
Accepted/In press2 Dec 2020
E-pub ahead of print24 Dec 2020
PublishedFeb 2021

Bibliographical note

Funding Information: This data was collected as part of the BUDAPEST-GLOBAL study. This study was funded by a grant from the EFSD New Horizons Program and Global Genomics Group, LLC. This work was supported by the Wellcome EPSRC Centre for Medical Engineering at King's College London (WT 203148/Z/16/Z) and the National Institute for Health Research Biomedical Research Centre at Guy's and St. Thomas? NHS Foundation Trust and King's College London. The views expressed here are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health. John Whitaker is funded by a Medical Research Council UK Clinical Research Training Fellowship (grant code MR/N001877/1). Publisher Copyright: © 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Aims: Left atrial (LA) remodelling is a common feature of many cardiovascular pathologies and is a sensitive marker of adverse cardiovascular outcomes. The aim of this study was to establish normal ranges for LA parameters derived from coronary computed tomographic angiography (CCTA) imaging using a standardised image processing pipeline to establish normal ranges in a previously described cohort. Methods: CCTA imaging from 193 subjects recruited to the Budapest GLOBAL twin study was analysed. Indexed LA cavity volume (LACV i), LA surface area (LASA i), wall thickness and LA tissue volume (LATV i) were calculated. Wall thickness maps were combined into an atlas. Indexed LA parameters were compared with clinical variables to identify early markers of pathological remodelling. Results: LACV i is similar between sexes (31 ml/m 2 v 30 ml/m 2) and increased in hypertension (33 ml/m 2 v 29 ml/m 2, p = 0.009). LASA i is greater in females than males (47.8 ml/m 2 v 45.8 ml/m 2 male, p = 0.031). Median LAWT was 1.45 mm. LAWT was lowest at the inferior portion of the posterior LA wall (1.14 mm) and greatest in the septum (median = 2.0 mm) (p < 0.001). Conditions known to predispose to the development of AF were not associated with differences in tissue thickness. Conclusions: The reported LACV i, LASA i, LATV i and tissue thickness derived from CCTA may serve as reference values for this age group and clinical characteristics for future studies. Increased LASA i in females in the absence of differences in LACV i or LATV i may indicate differential LA shape changes between the sexes. AF predisposing conditions, other than sex, were not associated with detectable changes in LAWT. Clinical trial registration: http://www.ClinicalTrials.gov/NCT01738828.

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