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

  • Raphael Hauser
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Anne Bjerg Nielsen
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Kristoffer Grundtvig Skaarup
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Mats Christian Højbjerg Lassen
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Lisa Steen Duus
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Niklas Dyrby Johansen
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Morten Sengeløv
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark
  • Jacob Louis Marott
    The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
  • Gorm Jensen
    The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
  • Peter Schnohr
    The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
  • Peter Søgaard
    The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
  • Rasmus Møgelvang
    The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
  • Tor Biering-Sørensen
    Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Copenhagen, Denmark

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Left atrial (LA) strain parameters have been demonstrated to be valuable predictors of atrial fibrillation (AF) in several patient cohorts. The purpose of this study was to investigate whether LA strain, assessed by two-dimensional speckle-tracking echocardiography, can be used to predict the development of AF in the general population.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>This prospective longitudinal study included 4466 participants from the fifth Copenhagen City Heart Study. All participants underwent a health examination, including echocardiographic measurements of LA strain. Participants with prevalent AF at baseline were excluded. The primary endpoint was incident AF. During a median follow-up period of 5.3 years, 154 (4.3%) participants developed AF. In univariable analysis, peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and LA strain during the conduit phase were significantly associated with the development of AF. PALS [hazard ratio (HR) 1.05, 95% confidence interval (CI) (1.03–1.07), P &lt; 0.001, per 1% decrease] and PACS (HR 1.08, 95% CI (1.05–1.12), P &lt; 0.001, per 1% decrease] remained independent predictors of AF in multivariable analysis. In addition, PALS and PACS remained significantly associated with AF development even in participants with normal-sized atria and normal left ventricular (LV) systolic function.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In the general population, PALS and PACS independently predict incident AF. These findings remained consistent even in participants with normal-sized LA and normal LV systolic function.</jats:p> </jats:sec>

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