Measures of left atrial function predict incident heart failure in a low-risk general population: the Copenhagen City Heart Study

Ditte Madsen Andersen*, Morten Sengeløv, Flemming Javier Olsen, Jacob Louis Marott, Gorm Boje Jensen, Peter Schnohr, Elke Platz, Morten Schou, Rasmus Mogelvang, Tor Biering-Sørensen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstract

Aims: This study investigated left atrial (LA) parameters as measured on transthoracic echocardiography as predictors of incident heart failure (HF) in a community cohort. Methods and results: In a large general population study (n = 2221), participants underwent a health examination with echocardiography. The maximum and minimum LA volumes indexed to body surface area (LAVImax and LAVImin) were measured and the LA emptying fraction (LAEF) and LA expansion index (LAEI) were calculated. Among 1951 participants without atrial fibrillation or significant valve disease, the mean age was 59 ± 16 years and 58% were women. At baseline, 1% (n = 16) had a left ventricular ejection fraction of <50%, 44% had hypertension, and 10% had diabetes. During follow-up (median 15.8 years, interquartile range: 11.3–16.2 years), 187 (10%) participants were diagnosed with incident HF. Participants who were diagnosed with HF during follow-up had a larger LAVImax and LAVImin and a lower LAEF and LAEI compared to participants without HF. In unadjusted analysis, LAVImax, LAVImin, LAEF and LAEI were predictors of incident HF. After multivariable adjustment for clinical and echocardiographic parameters, only LAVImin remained an independent predictor of incident HF (hazard ratio per 1 standard deviation increase: 1.22 [95% confidence interval 1.01–1.47], p = 0.038). Conclusion: In the general population, LAVImin is an independent predictor of incident HF. LAVImax, currently the only LA measure in a routine echocardiographic examination, was not an independent predictor of incident HF.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Heart Failure
Vol/bind24
Udgave nummer3
Sider (fra-til)483-493
ISSN1388-9842
DOI
StatusUdgivet - 2022

Bibliografisk note

Publisher Copyright:
© 2021 European Society of Cardiology.

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