Left Atrial Reservoir Function as a Potent Marker for First Atrial Fibrillation or Flutter in Persons ≥ 65 Years of Age

Walter P. Abhayaratna, Kaniz Fatema, Marion E. Barnes, James B. Seward, Bernard J. Gersh, Kent R Bailey, Grace Casaclang-Verzosa, Teresa S M Tsang

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

The aim of this prospective study was to evaluate the incremental value of left atrial (LA) function for the prediction of risk for first atrial fibrillation (AF) or atrial flutter. Maximum and minimum LA volumes were quantitated by echocardiography in 574 adults (mean age 74 ± 6 years, 52% men) without a history or evidence of atrial arrhythmia. During a mean follow-up period of 1.9 ± 1.2 years, 30 subjects (5.2%) developed electrocardiographically confirmed AF or atrial flutter. Subjects with new AF or atrial flutter had lower LA reservoir function, as measured by total LA emptying fraction (38% vs 49%, p <0.0001) and higher maximum LA volumes (47 vs 40 ml/m2, p = 0.005). An increase in age-adjusted risk for AF or atrial flutter was evident when the cohort was stratified according to medians of LA emptying fraction (≤49%: hazard ratio 6.5, p = 0.001) and LA volume (≥38 ml/m2: hazard ratio 2.0, p = 0.07), with the risk being highest for subjects with concomitant LA emptying fractions ≤49% and LA volume ≥38 ml/m2 (hazard ratio 9.3, p = 0.003). LA emptying fraction (p = 0.002) was associated with risk for first AF or atrial flutter after adjusting for baseline clinical risk factors for AF or atrial flutter, left ventricular ejection fraction, diastolic function grade, and LA volume. In conclusion, reduced LA reservoir function markedly increases the propensity for first AF or atrial flutter, independent of LA volume, left ventricular function, and clinical risk factors.

Original languageEnglish (US)
Pages (from-to)1626-1629
Number of pages4
JournalAmerican Journal of Cardiology
Volume101
Issue number11
DOIs
StatePublished - Jun 1 2008

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Left Atrial Function
Atrial Flutter
Atrial Fibrillation
Left Ventricular Function
Stroke Volume
Echocardiography
Cardiac Arrhythmias
History
Prospective Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Left Atrial Reservoir Function as a Potent Marker for First Atrial Fibrillation or Flutter in Persons ≥ 65 Years of Age. / Abhayaratna, Walter P.; Fatema, Kaniz; Barnes, Marion E.; Seward, James B.; Gersh, Bernard J.; Bailey, Kent R; Casaclang-Verzosa, Grace; Tsang, Teresa S M.

In: American Journal of Cardiology, Vol. 101, No. 11, 01.06.2008, p. 1626-1629.

Research output: Contribution to journalArticle

Abhayaratna, WP, Fatema, K, Barnes, ME, Seward, JB, Gersh, BJ, Bailey, KR, Casaclang-Verzosa, G & Tsang, TSM 2008, 'Left Atrial Reservoir Function as a Potent Marker for First Atrial Fibrillation or Flutter in Persons ≥ 65 Years of Age', American Journal of Cardiology, vol. 101, no. 11, pp. 1626-1629. https://doi.org/10.1016/j.amjcard.2008.01.051
Abhayaratna, Walter P. ; Fatema, Kaniz ; Barnes, Marion E. ; Seward, James B. ; Gersh, Bernard J. ; Bailey, Kent R ; Casaclang-Verzosa, Grace ; Tsang, Teresa S M. / Left Atrial Reservoir Function as a Potent Marker for First Atrial Fibrillation or Flutter in Persons ≥ 65 Years of Age. In: American Journal of Cardiology. 2008 ; Vol. 101, No. 11. pp. 1626-1629.
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abstract = "The aim of this prospective study was to evaluate the incremental value of left atrial (LA) function for the prediction of risk for first atrial fibrillation (AF) or atrial flutter. Maximum and minimum LA volumes were quantitated by echocardiography in 574 adults (mean age 74 ± 6 years, 52{\%} men) without a history or evidence of atrial arrhythmia. During a mean follow-up period of 1.9 ± 1.2 years, 30 subjects (5.2{\%}) developed electrocardiographically confirmed AF or atrial flutter. Subjects with new AF or atrial flutter had lower LA reservoir function, as measured by total LA emptying fraction (38{\%} vs 49{\%}, p <0.0001) and higher maximum LA volumes (47 vs 40 ml/m2, p = 0.005). An increase in age-adjusted risk for AF or atrial flutter was evident when the cohort was stratified according to medians of LA emptying fraction (≤49{\%}: hazard ratio 6.5, p = 0.001) and LA volume (≥38 ml/m2: hazard ratio 2.0, p = 0.07), with the risk being highest for subjects with concomitant LA emptying fractions ≤49{\%} and LA volume ≥38 ml/m2 (hazard ratio 9.3, p = 0.003). LA emptying fraction (p = 0.002) was associated with risk for first AF or atrial flutter after adjusting for baseline clinical risk factors for AF or atrial flutter, left ventricular ejection fraction, diastolic function grade, and LA volume. In conclusion, reduced LA reservoir function markedly increases the propensity for first AF or atrial flutter, independent of LA volume, left ventricular function, and clinical risk factors.",
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AU - Seward, James B.

AU - Gersh, Bernard J.

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AU - Casaclang-Verzosa, Grace

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AB - The aim of this prospective study was to evaluate the incremental value of left atrial (LA) function for the prediction of risk for first atrial fibrillation (AF) or atrial flutter. Maximum and minimum LA volumes were quantitated by echocardiography in 574 adults (mean age 74 ± 6 years, 52% men) without a history or evidence of atrial arrhythmia. During a mean follow-up period of 1.9 ± 1.2 years, 30 subjects (5.2%) developed electrocardiographically confirmed AF or atrial flutter. Subjects with new AF or atrial flutter had lower LA reservoir function, as measured by total LA emptying fraction (38% vs 49%, p <0.0001) and higher maximum LA volumes (47 vs 40 ml/m2, p = 0.005). An increase in age-adjusted risk for AF or atrial flutter was evident when the cohort was stratified according to medians of LA emptying fraction (≤49%: hazard ratio 6.5, p = 0.001) and LA volume (≥38 ml/m2: hazard ratio 2.0, p = 0.07), with the risk being highest for subjects with concomitant LA emptying fractions ≤49% and LA volume ≥38 ml/m2 (hazard ratio 9.3, p = 0.003). LA emptying fraction (p = 0.002) was associated with risk for first AF or atrial flutter after adjusting for baseline clinical risk factors for AF or atrial flutter, left ventricular ejection fraction, diastolic function grade, and LA volume. In conclusion, reduced LA reservoir function markedly increases the propensity for first AF or atrial flutter, independent of LA volume, left ventricular function, and clinical risk factors.

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