Changes in left atrial structure and function over a decade in the general population
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Changes in left atrial structure and function over a decade in the general population. / Olsen, Flemming Javier; Johansen, Niklas Dyrby; Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Højbjerg; Ravnkilde, Kirstine; Schnohr, Peter; Jensen, Gorm Boje; Marott, Jacob Louis; Søgaard, Peter; Møgelvang, Rasmus; Biering-Sørensen, Tor.
I: European Heart Journal Cardiovascular Imaging, Bind 23, Nr. 1, 2022, s. 124-136.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Changes in left atrial structure and function over a decade in the general population
AU - Olsen, Flemming Javier
AU - Johansen, Niklas Dyrby
AU - Skaarup, Kristoffer Grundtvig
AU - Lassen, Mats Christian Højbjerg
AU - Ravnkilde, Kirstine
AU - Schnohr, Peter
AU - Jensen, Gorm Boje
AU - Marott, Jacob Louis
AU - Søgaard, Peter
AU - Møgelvang, Rasmus
AU - Biering-Sørensen, Tor
N1 - Publisher Copyright: © The Author(s) 2021.
PY - 2022
Y1 - 2022
N2 - Aims: Assessing left atrial (LA) size and function is an important part of the echocardiographic examination. We sought to assess how LA size and function develop over time, and which clinical characteristics promote atrial remodelling. Methods and results: We examined longitudinal changes of the LA between two visits in the Copenhagen City Heart Study (n = 1065). The median time between the examinations was 10.4 years. LA measurements included: maximal LA volume (LAVmax), minimal LA volume (LAVmin), and LA emptying fraction (LAEF). Clinical and echocardiographic accelerators were determined from linear regression. The value of LA remodelling for predicting incident atrial fibrillation (AF) and heart failure (HF) was examined by Cox proportional hazards regressions. During follow-up, LAVmax and LAVmin significantly increased by 8.3 and 3.5 mL/m2, respectively. LAEF did not change. Age and AF were the most impactful clinical accelerators of LA remodelling with standardized beta-coefficients of 0.17 and 0.28 for changes in LAVmax, and 0.18 and 0.38 for changes in LAVmin, respectively. Left ventricular (LV) systolic function, diameter, and mass were also significant accelerators of LA remodelling. Changes in both LAVmax and LAVmin were significantly associated with incident AF [n = 46, ΔLAVmax: HR = 1.06 (1.03-1.09), P < 0.001 and ΔLAVmin: HR = 1.14 (1.10-1.18), P < 0.001, per 1 mL/m2 increase] and HF [n = 27, ΔLAVmax: HR = 1.08 (1.04-1.12), P < 0.001 and ΔLAVmin: HR = 1.13 (1.09-1.18), P < 0.001, per 1 mL/m2 increase]. Conclusion: Both maximal and minimal LA volume increase over time. Clinical accelerators included age and AF. LV structure and systolic function also accelerate LA remodelling. LA remodelling poses an increased risk of clinical outcomes.
AB - Aims: Assessing left atrial (LA) size and function is an important part of the echocardiographic examination. We sought to assess how LA size and function develop over time, and which clinical characteristics promote atrial remodelling. Methods and results: We examined longitudinal changes of the LA between two visits in the Copenhagen City Heart Study (n = 1065). The median time between the examinations was 10.4 years. LA measurements included: maximal LA volume (LAVmax), minimal LA volume (LAVmin), and LA emptying fraction (LAEF). Clinical and echocardiographic accelerators were determined from linear regression. The value of LA remodelling for predicting incident atrial fibrillation (AF) and heart failure (HF) was examined by Cox proportional hazards regressions. During follow-up, LAVmax and LAVmin significantly increased by 8.3 and 3.5 mL/m2, respectively. LAEF did not change. Age and AF were the most impactful clinical accelerators of LA remodelling with standardized beta-coefficients of 0.17 and 0.28 for changes in LAVmax, and 0.18 and 0.38 for changes in LAVmin, respectively. Left ventricular (LV) systolic function, diameter, and mass were also significant accelerators of LA remodelling. Changes in both LAVmax and LAVmin were significantly associated with incident AF [n = 46, ΔLAVmax: HR = 1.06 (1.03-1.09), P < 0.001 and ΔLAVmin: HR = 1.14 (1.10-1.18), P < 0.001, per 1 mL/m2 increase] and HF [n = 27, ΔLAVmax: HR = 1.08 (1.04-1.12), P < 0.001 and ΔLAVmin: HR = 1.13 (1.09-1.18), P < 0.001, per 1 mL/m2 increase]. Conclusion: Both maximal and minimal LA volume increase over time. Clinical accelerators included age and AF. LV structure and systolic function also accelerate LA remodelling. LA remodelling poses an increased risk of clinical outcomes.
KW - echocardiography
KW - left atrium
KW - longitudinal
KW - remodelling
UR - http://www.scopus.com/inward/record.url?scp=85124538227&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jeab173
DO - 10.1093/ehjci/jeab173
M3 - Journal article
C2 - 34468711
AN - SCOPUS:85124538227
VL - 23
SP - 124
EP - 136
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 1
ER -
ID: 311612480