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

Autor: Sardana M; Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA mayank.mamc@gmail.com., Lessard D; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA., Tsao CW; Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA., Parikh NI; Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, CA., Barton BA; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA., Nah G; Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, CA., Thomas RC; Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, CA., Cheng S; 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., Schiller NB; Cardiology Division, Department of Medicine, University of California San Francisco, San Francisco, CA., Aragam JR; Cardiology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Veterans Administration Medical Center, West Roxbury, and Harvard Medical School, Boston, MA., Mitchell GF; Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA.; Cardiovascular Engineering, Inc, Norwood, MA., Vaze A; Department of Medicine, University of Massachusetts Medical School, Worcester, MA., Benjamin EJ; Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA.; Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Department of Medicine, and Department of Epidemiology, Boston University Schools of Medicine and Public Health, Boston, MA., Vasan RS; Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA.; Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Department of Medicine, and Department of Epidemiology, Boston University Schools of Medicine and Public Health, Boston, MA., McManus DD; Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, MA.; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2018 Mar 30; Vol. 7 (7). Date of Electronic Publication: 2018 Mar 30.
DOI: 10.1161/JAHA.117.008435
Abstrakt: Background: Left 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 Results: In 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.
Conclusions: In 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.
(© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)
Databáze: MEDLINE
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