Morphometrical observation on the left atrium in human adults

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Abstract

Aim. To determine the left atrial dimensions, their ratios and relationships that characterize anatomy for left atrium structure in the normal human adult using the model of the atrial end-diastolic phase.

Methods. We studied 54 heart specimens of subjects aged 35–88 years who died from non-cardiac causes. The atrial end-diastolic phase was modeled by filling a specimen fixed in 1% formalin with liquid silicone. After silicone hardened, we performed morphometric measurements by a caliper. The data were processed by using a cluster, correlation and variance analysis. For pairwise comparison, we used the Mann–Whitney U-test or a ­two-sided t-test.

Results. The article presents mean, standard deviation, median, 25th percentile and 75th percentile and coefficients of variation for the length, width and sagittal size of the left atrium, as well as the values of the distances between the pulmonary vein orifices, which characterize the dimensions of the left atrium posterior wall. Based on the left atrial size differences and their ratios, the specimens were divided into three clusters. The first (n1=23) and second clusters (n2=10) were represented by hearts with a cubic atrium; the second group differed from the first in the larger size of the left atrium. The third cluster (n3=21) included the hearts in which the largest left atrium size was the width, so the shape of the atria resembled a parallelepiped. The typical number of the pulmonary vein ostia we found in 91% of the specimens. The posterior wall of the left atrium, with a common number and topography of the ostia, were rectangle or an unequal trapezium in shape. We analyzed correlations between the sizes of the heart, left atrium and its posterior wall. We concretized the conceptual apparatus concerning the nomenclature and terminology of the left atrium anatomical structures.

Conclusion. Based on the size ratio, two shape variations of the left atrium body can be identified: cubic or parallelepiped; cubic atria can be divided into large and small; the co-directional dimensions of the left atrial body and its posterior wall showed the strongest correlations.

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About the authors

A A Gaponov

Ural State Medical University

Email: ayakimov07@mail.ru
Russian Federation, Ekaterinburg, Russia

M E Noskova

Ural State Medical University

Email: ayakimov07@mail.ru
Russian Federation, Ekaterinburg, Russia

A A Iakimov

Ural State Medical University; Ural Federal University

Author for correspondence.
Email: ayakimov07@mail.ru
Russian Federation, Ekaterinburg, Russia; Ekaterinburg, Russia;

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Supplementary files

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2. Рис. 1. Ориентиры для морфометрии левого предсердия. Вид со стороны диафрагмальной поверхности (рис. 1, А) и со стороны задней стенки левого предсердия. Левое предсердие заполнено силиконом, на рис. 1, Б миокард отпрепарирован. Д — длина; Ш — ширина; СР — сагиттальный размер левого предсердия. Знаками * и # отмечены участки устьев лёгочных вен, между которыми измеряли соответственно внутренние и наружные размеры задней стенки левого предсердия

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3. Рис. 2. Габаритные размеры тела левого предсердия сердца (ЛП). Данные представлены в виде медиан (точки в прямоугольниках), 25-го и 75-го процентилей (соответственно нижняя и верхняя границы прямоугольников) и крайних значений (отрезки)

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4. Рис. 3. Варианты формы и размеров левого предсердия: А — малый кубический; Б — большой кубический; В — в форме параллелепипеда. Левое предсердие заполнено застывшим силиконом. Вид со стороны диафрагмальной поверхности сердца

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