The association of left atrial volume with age, ethnicity and cardiovascular risk factors in men and women: the Multi-Ethnic Study of Atherosclerosis (MESA)

Methods LA volume indexed to body surface area (LAVi) was measured by CMR using steady-state free precession cine long and short axis images in 2576 participants of the MultiEthnic Study of Atherosclerosis (68.7 years, 53.0% women). We used gender stratified regression models to evaluate the association of LAVi as the dependent variable with demographic and cardiovascular risk factors, left ventricular (LV) parameters and diagnosis of coronary heart disease as independent variables. LAVi between ethnicities were compared using analysis of variance (ANOVA) with Tukey’s post-hoc analysis. To determine normal LA dimensions we also selected a group of participants with normal body mass index (≥18.5 and u003c 25 kg/m), without hypertension, diabetes, coronary heart disease, congestive heart failure, LV systolic dysfunction (defined as ejection fraction less than 50%), LV hypertrophy or atrial fibrillation (n = 285, 65.6 years, 61.8% women). Results The unadjusted mean LA volume index in the whole cohort was 36.5 ± 11.4 ml/m and was 9% smaller in men (35.9 ± 11.1 vs. 37.0 ± 11.6 ml/m, p u003c 0.05). LAVi was greater with age in men (b = 0.2 ml/m/yr, p u003c 0.0001) and women (b = 0.3 ml/m/yr, p u003c 0.0001). Both Chinese American men and women had significantly (p u003c 0.05) smaller LAVi compared to other ethnicities (Figure 2). History of coronary disease was associated with 10% larger LAVi in women (b=3.7 ml/m, p u003c 0.05), but not in men (p = ns). In the normal reference cohort free of cardiovascular disease there were no differences in LAVi by gender (men 34.5 ± 9.9 ml/m, women 36.0 ± 10.2 ml/m, p = 0.30).