Usefulness of left atrial strain for predicting incident atrial fibrillation and ischaemic stroke in the general population
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Usefulness of left atrial strain for predicting incident atrial fibrillation and ischaemic stroke in the general population. / Alhakak, Alia Saed; Biering-Sørensen, Sofie Reumert; Møgelvang, Rasmus; Modin, Daniel; Jensen, Gorm Boje; Schnohr, Peter; Iversen, Allan Zeeberg; Svendsen, Jesper Hastrup; Jespersen, Thomas; Gislason, Gunnar; Biering-Sørensen, Tor.
In: European heart journal. Cardiovascular Imaging, Vol. 23, No. 3, 2022, p. 363-371.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Usefulness of left atrial strain for predicting incident atrial fibrillation and ischaemic stroke in the general population
AU - Alhakak, Alia Saed
AU - Biering-Sørensen, Sofie Reumert
AU - Møgelvang, Rasmus
AU - Modin, Daniel
AU - Jensen, Gorm Boje
AU - Schnohr, Peter
AU - Iversen, Allan Zeeberg
AU - Svendsen, Jesper Hastrup
AU - Jespersen, Thomas
AU - Gislason, Gunnar
AU - Biering-Sørensen, Tor
N1 - Publisher Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
PY - 2022
Y1 - 2022
N2 - AIMS: Left atrial enlargement predicts incident atrial fibrillation (AF). However, the prognostic value of peak atrial longitudinal strain (PALS) for predicting incident AF in participants from the general population is currently unknown. Our aim was to investigate if PALS can be used to predict AF and ischaemic stroke in the general population. METHODS AND RESULTS: A total of 400 participants from the general population underwent a health examination, including two-dimensional speckle tracking echocardiography of the left atrium. The primary endpoint was incident AF at follow-up. All participants with known AF and prior stroke at baseline were excluded (n = 54). The secondary endpoint consisted of the composite of AF and ischaemic stroke. During a median follow-up of 16 years, 36 participants (9%) were diagnosed with incident AF and 30 (7%) experienced an ischaemic stroke, resulting in 66 (16%) experiencing the composite outcome. PALS was a univariable predictor of AF [per 5% decrease: hazard ratio (HR) 1.42; 95% confidence interval (CI) (1.19-1.69), P < 0.001]. However, the prognostic value of PALS was modified by age (P = 0.002 for interaction). After multivariable adjustment PALS predicted AF in participants aged <65 years [per 5% decrease: HR 1.46; 95% CI (1.06-2.02), P = 0.021]. In contrast, PALS did not predict AF in participants aged ≥65 years after multivariable adjustment [per 5% decrease: HR 1.05; 95% CI (0.81-1.35), P = 0.72]. PALS also predicted the secondary endpoint in participants aged <65 years and the association remained significant after multivariable adjustment. CONCLUSION: In a low-risk general population, PALS provides novel prognostic information on the long-term risk of AF and ischaemic stroke in participants aged <65 years.
AB - AIMS: Left atrial enlargement predicts incident atrial fibrillation (AF). However, the prognostic value of peak atrial longitudinal strain (PALS) for predicting incident AF in participants from the general population is currently unknown. Our aim was to investigate if PALS can be used to predict AF and ischaemic stroke in the general population. METHODS AND RESULTS: A total of 400 participants from the general population underwent a health examination, including two-dimensional speckle tracking echocardiography of the left atrium. The primary endpoint was incident AF at follow-up. All participants with known AF and prior stroke at baseline were excluded (n = 54). The secondary endpoint consisted of the composite of AF and ischaemic stroke. During a median follow-up of 16 years, 36 participants (9%) were diagnosed with incident AF and 30 (7%) experienced an ischaemic stroke, resulting in 66 (16%) experiencing the composite outcome. PALS was a univariable predictor of AF [per 5% decrease: hazard ratio (HR) 1.42; 95% confidence interval (CI) (1.19-1.69), P < 0.001]. However, the prognostic value of PALS was modified by age (P = 0.002 for interaction). After multivariable adjustment PALS predicted AF in participants aged <65 years [per 5% decrease: HR 1.46; 95% CI (1.06-2.02), P = 0.021]. In contrast, PALS did not predict AF in participants aged ≥65 years after multivariable adjustment [per 5% decrease: HR 1.05; 95% CI (0.81-1.35), P = 0.72]. PALS also predicted the secondary endpoint in participants aged <65 years and the association remained significant after multivariable adjustment. CONCLUSION: In a low-risk general population, PALS provides novel prognostic information on the long-term risk of AF and ischaemic stroke in participants aged <65 years.
KW - stroke
KW - atrial fibrillation
KW - general population
KW - long-term outcome
KW - peak atrial longitudinal strain
KW - two-dimensional speckle tracking echocardiography
U2 - 10.1093/ehjci/jeaa287
DO - 10.1093/ehjci/jeaa287
M3 - Journal article
C2 - 33175146
AN - SCOPUS:85125016119
VL - 23
SP - 363
EP - 371
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 3
ER -
ID: 299560784