Raphael Hauser1, Anne Bjerg Nielsen1, Kristoffer Grundtvig Skaarup1, Mats Christian Højbjerg Lassen1, Lisa Steen Duus1, Niklas Dyrby Johansen1, Morten Sengeløv1, Jacob Louis Marott2, Gorm Jensen2, Peter Schnohr2, Peter Søgaard2,3,4, Rasmus Møgelvang2,5,6,7, Tor Biering-Sørensen1,2,7. 1. Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark. 2. The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. 3. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark. 4. Institute of Clinical Medicine, Faculty of Medicine, University of Aalborg, Aalborg, Denmark. 5. Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. 6. Cardiovascular Research Unit, University of Southern Denmark, Baagøes Allé 15, 5700 Svendborg, Denmark. 7. Institute of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
Abstract
BACKGROUND: Left atrial (LA) strain parameters have been demonstrated to be valuable predictors of atrial fibrillation (AF) in several patient cohorts. The purpose of this study was to investigate whether LA strain, assessed by two-dimensional speckle-tracking echocardiography, can be used to predict the development of AF in the general population. METHODS AND RESULTS: This prospective longitudinal study included 4466 participants from the fifth Copenhagen City Heart Study. All participants underwent a health examination, including echocardiographic measurements of LA strain. Participants with prevalent AF at baseline were excluded. The primary endpoint was incident AF. During a median follow-up period of 5.3 years, 154 (4.3%) participants developed AF. In univariable analysis, peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and LA strain during the conduit phase were significantly associated with the development of AF. PALS [hazard ratio (HR) 1.05, 95% confidence interval (CI) (1.03-1.07), P < 0.001, per 1% decrease] and PACS (HR 1.08, 95% CI (1.05-1.12), P < 0.001, per 1% decrease] remained independent predictors of AF in multivariable analysis. In addition, PALS and PACS remained significantly associated with AF development even in participants with normal-sized atria and normal left ventricular (LV) systolic function. CONCLUSION: In the general population, PALS and PACS independently predict incident AF. These findings remained consistent even in participants with normal-sized LA and normal LV systolic function. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Left atrial (LA) strain parameters have been demonstrated to be valuable predictors of atrial fibrillation (AF) in several patient cohorts. The purpose of this study was to investigate whether LA strain, assessed by two-dimensional speckle-tracking echocardiography, can be used to predict the development of AF in the general population. METHODS AND RESULTS: This prospective longitudinal study included 4466 participants from the fifth Copenhagen City Heart Study. All participants underwent a health examination, including echocardiographic measurements of LA strain. Participants with prevalent AF at baseline were excluded. The primary endpoint was incident AF. During a median follow-up period of 5.3 years, 154 (4.3%) participants developed AF. In univariable analysis, peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and LA strain during the conduit phase were significantly associated with the development of AF. PALS [hazard ratio (HR) 1.05, 95% confidence interval (CI) (1.03-1.07), P < 0.001, per 1% decrease] and PACS (HR 1.08, 95% CI (1.05-1.12), P < 0.001, per 1% decrease] remained independent predictors of AF in multivariable analysis. In addition, PALS and PACS remained significantly associated with AF development even in participants with normal-sized atria and normal left ventricular (LV) systolic function. CONCLUSION: In the general population, PALS and PACS independently predict incident AF. These findings remained consistent even in participants with normal-sized LA and normal LV systolic function. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: 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 Journal: Eur J Heart Fail Date: 2022-01-05 Impact factor: 15.534