Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women
Abstract
Objective To evaluate the contribution of left atrial (LA) volume in predicting atrial fibrillation (AF).Patients and methods In this retrospective cohort study, a random sample of 2200 adults was identified from all Olmsted County, Minnesota, residents who had undergone transthoracic echocardiographic assessment between 1990 and 1998 and were 65 years of age or older at the time of examination, were in sinus rhythm, and had no history of AF or other atrial arrhythmias, stroke, pacemaker, congenital heart disease, or valve surgery. The LA volume was measured off-line by using a biplane area-length method. Clinical characteristics and the outcome event of incident AF were determined by retrospective review of medical records. Echocardiographic data were retrieved from the laboratory database. From this cohort, 1655 patients in whom LA size data were available were followed from baseline echocardiogram until development of AF or death. The clinical and echocardiographic associations of AF, especially with respect to the role of LA volume in predicting AF, were determined.Results A total of 666 men and 989 women, mean +/- SD age of 75.2 +/- 7.3 years (range, 65-105 years), were followed for a mean +/- SD of 3.97 +/- 2.75 years (range, < 1.00-10.78 years); 189 (11.4%) developed AF. Cox model 5-year cumulative risks of AF by quartiles of LA volume were 3%, 12%, 15%, and 26%, respectively. With Cox proportional hazards multivariate models, logarithmic LA volume was an independent predictor of AF, incremental to clinical risk factors. After adjusting for age, sex, valvular heart disease, and hypertension, a 30% larger LA volume was associated with a 43% greater risk of AF, incremental to history of congestive heart failure (hazard ratio [HR], 1.887; 95% confidence interval [CI], 1.230-2.895; P = .004), myocardial infarction (HR, 1.751; 95% CI, 1.189-2.577; P = .004), and diabetes (HR, 1.734; 95% CI, 1.066-2.819; P = .03). Left atrial volume remained incremental to combined clinical risk factors and M-mode LA dimension for prediction of AF (P < .001).Conclusion This study showed that a larger LA volume was associated with a higher risk of AF in older patients. The predictive value of LA volume was incremental to that of clinical risk profile and conventional M-mode LA dimension.
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The link between female sex and stroke might vary across populations and age groups.
“The link between female sex and stroke might vary across populations and age groups.75–84”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [79]
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- Authors
- Tsang, T. S. M., Barnes, M. E., Bailey, K. R., Leibson, C. L., Montgomery, S. C., Takemoto, Y., Diamond, P. M., Marra, M. A., Gersh, B. J., Wiebers, D. O., Petty, G. W., & Seward, J. B.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Tsang, Teresa S.M.
- ORCID
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2001-05
- Volume
- 76
- Issue
- 5
- Pages
- 467-475
- ISSN
- 0025-6196 (ISSN-L)
- OpenAlex
- W2078519118
- Cited by
- 631
- References
- 30
- Citations by year
- 2026: 23 · 2025: 14 · 2024: 33 · 2023: 21 · 2022: 33 · 2021: 26 · 2020: 33 · 2019: 37 · 2018: 33 · 2017: 32 · 2016: 39 · 2015: 33 · 2014: 40 · 2013: 25 · 2012: 24
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Keywords
- left atrial volume, atrial fibrillation, incident atrial fibrillation, risk prediction, older adults, transthoracic echocardiography, congestive heart failure, myocardial infarction, diabetes mellitus, hypertension, valvular heart disease, atrial remodeling, Olmsted County cohort
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Cardiac Volume, Echocardiography, Electrocardiography, Female, Humans, Male, Predictive Value of Tests, Retrospective Studies, Risk Factors, Comorbidity, Chi-Square Distribution
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