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Bispebjerg Hospital - a part of Copenhagen University Hospital
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Changes in left atrial structure and function over a decade in the general population

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  1. Usefulness of left atrial strain for predicting incident atrial fibrillation and ischaemic stroke in the general population

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Left atrial strain predicts incident atrial fibrillation in the general population: the Copenhagen City Heart Study

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  3. Normal values and reference ranges for left atrial strain by speckle-tracking echocardiography: the Copenhagen City Heart Study

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  4. Echocardiographic predictors of cardiovascular morbidity and mortality in women from the general population

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  1. Measures of left atrial function predict incident heart failure in a low-risk general population: the Copenhagen City Heart Study

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  2. Association between Isometric and Allometric Height-Indexed Left Atrial Size and Atrial Fibrillation

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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.

Original languageEnglish
JournalEuropean Heart Journal Cardiovascular Imaging
Volume23
Issue number1
Pages (from-to)124-136
Number of pages13
ISSN1525-2167
DOIs
Publication statusPublished - 2022

Bibliographical note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.

ID: 68133956