Association of Left Atrial Function Index with Atrial Fibrillation and Cardiovascular Disease: The Framingham Offspring Study

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Susan Cheng¹  Gary F. Mitchell¹  Ramachandran S. Vasan¹  Emelia J. Benjamin¹  Jayashri R. Aragam²  Randell C. Thomas³  Nisha I. Parikh³  Gregory Nah³  Nelson B. Schiller³  Mayank Sardana⁴  David D. McManus⁴  Connie W. Tsao⁵  Aditya Vaze⁶  Bruce A. Barton⁷  Darleen Lessard⁷ 

[1] Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA;Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA;Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, CA;Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA;Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA;Department of Medicine, University of Massachusetts Medical School, Worcester, MA;Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA;

关键词: atrial fibrillation;    cardiovascular disease;    echocardiography;    epidemiology;    left atrium;   

DOI  :  10.1161/JAHA.117.008435

来源: DOAJ

【 摘 要 】

BackgroundLeft atrial (LA) size, a marker of atrial structural remodeling, is associated with increased risk for atrial fibrillation (AF) and cardiovascular disease (CVD). LA function may also relate to AF and CVD, irrespective of LA structure. We tested the hypothesis that LA function index (LAFI), an echocardiographic index of LA structure and function, may better characterize adverse LA remodeling and predict incident AF and CVD than existing measures. Methods and ResultsIn 1786 Framingham Offspring Study eighth examination participants (mean age, 66±9 years; 53% women), we related LA diameter and LAFI (derived from the LA emptying fraction, left ventricular outflow tract velocity time integral, and indexed maximal LA volume) to incidence of AF and CVD on follow‐up. Over a median follow‐up of 8.3 years (range, 7.5–9.1 years), 145 participants developed AF and 139 developed CVD. Mean LAFI was 34.5±12.7. In adjusted Cox regression models, lower LAFI was associated with higher risk of incident AF (hazard ratio=3.83, 95% confidence interval=2.23–6.59, lowest [Q1] compared with highest [Q4] LAFI quartile) and over 2‐fold higher risk of incident CVD (hazard ratio=2.20, 95% confidence interval=1.32–3.68, Q1 versus Q4). Addition of LAFI, indexed maximum LA volume, or LA diameter to prediction models for AF or CVD did not significantly improve model discrimination for either outcome. ConclusionsIn our prospective investigation of a moderate‐sized community‐based sample, LAFI, a composite measure of LA size and function, was associated with incident AF and CVD. Addition of LAFI to the risk prediction models for AF or CVD, however, did not significantly improve their performance.

【 授权许可】

Unknown