Author + information
- Ditte Andersen,
- Jan Skov Jensen,
- Rasmus Mogelvang,
- Peter Schnohr and
- Tor Biering-Sorensen
Background: The left atrium (LA) size is a significant predictor of heart failure (HF) in various populations and is currently the only LA parameter included in a standardized echocardiography; however, the LA emptying fraction (LAEF), which reflects LA function, may be superior in predicting cardiovascular morbidity, including future heart failure (HF) and acute myocardial infarction (AMI) as well as cardiovascular death (CVD) in the general population.
Method: In a large general population study, 2,017 participants underwent a health examination with echocardiography. The maximal LA volume (LAVmax) and the minimal LA volume (LAVmin) were measured and the LAEF was calculated (LAEF=(LAVmax-LAVmin)/ LAVmax). Participants with a history of previous heart failure or atrial fibrillation were excluded (n=213).
Results: The population had a mean age of 59 years, 42% were men, 44% had hypertension, 10% had diabetes and mean left ventricular ejection fraction (LVEF) was 60%. During follow-up (median 11.0 years), 134 (6.9%) participants were diagnosed with incident HF, 43 (2.2%) participants were diagnosed with AMI and 132 (6.8%) suffered from CVD.
In univariable analysis, LAEF proved to be a predictor of incident HF and CVD (HR 1.22, p<0.001 and HR 1.18, p<0.001 per 5% decrease, respectively). LAEF was not found to be a predictor of future AMI (HR 1.06, p=0.15 per 5% decrease)
After multivariable adjustment for clinical and echocardiographic parameters (age, sex, body mass index, hypertension, diabetes, smoking status, ischemic heart disease, ischemic stroke, estimated glomerular filtration rate, heart rate, systolic blood pressure, left ventricular mass index, E/e’ and LVEF <50%) only LAEF remained an independent predictor of incident HF (HR 1.12 (CI 1.04-1.21), p=0.003 per 5% decrease).
Even after restricting the analysis to only include participants with a normal LA volume (LAVmax < 34 mL/m2), the LAEF remained an independent predictor of incident heart failure (HR 1.14 (CI 1.05-1.23), p=0.001 per 5% decrease).
Conclusions: The measure of LA function, LAEF, is a strong and independent predictor of incident HF in the general population, and provides prognostic information incremental to LA size.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Innovative Use of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1197-217
- 2017 American College of Cardiology Foundation