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Clinical Trial
. 2010 Feb 9;121(5):667-74.
doi: 10.1161/CIRCULATIONAHA.109.885806. Epub 2010 Jan 25.

Longitudinal tracking of left atrial diameter over the adult life course: Clinical correlates in the community

David D McManus  1 , Vanessa Xanthakis, Lisa M Sullivan, Justin Zachariah, Jayashri Aragam, Martin G Larson, Emelia J Benjamin, Ramachandran S Vasan
Affiliations
Clinical Trial

Longitudinal tracking of left atrial diameter over the adult life course: Clinical correlates in the community

David D McManus et al. Circulation. .

Abstract

Background: Increased left atrial diameter (LAD) is associated with elevated risk of atrial fibrillation (AF) and cardiovascular disease. Information is limited regarding the short- or long-term correlates of LAD.

Methods and results: We evaluated clinical correlates of LAD for a 16-year period in 4403 Framingham Study participants (mean age, 45 years; 52% women; median observations/participant=3) using multilevel modeling. We related age, sex, body mass index (BMI), systolic and diastolic blood pressure (BP), diabetes, and antihypertensive treatment to LAD. Sex-specific growth curves for LAD were estimated for individuals with low, intermediate, and high risk factor burden. We also related risk factors to changes in LAD during a 4-year period in 3365 participants. Age, male sex (3.83 mm compared to women), greater BMI, higher systolic BP (0.24 mm per 10 mm Hg increment), and antihypertensive treatment (0.54 mm) were associated positively with LAD (P<0.001). Men had a greater increase in LAD with BMI than women (2.02 versus 1.77 mm in women, per 5-unit increment), and individuals receiving antihypertensive treatment experienced a greater increase in LAD with age (0.95 versus 0.63 mm per 10-year age increment) when compared with those not receiving antihypertensive treatment. Overall, greater risk factor burden was positively associated with LAD. These risk factors were also associated positively with 4-year change in LAD (P<0.001).

Conclusions: Our longitudinal study of a large community-based sample identified higher BP and greater BMI as key modifiable correlates of LAD, suggesting that maintaining optimal levels of these risk factors through the life course may prevent atrial remodeling and AF.

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Conflict of interest statement

Conflict of Interest Disclosures: none

Figures

Figure 1
Figure 1
Overview of study design. Δ indicates change; LAD, left atrial dimension
Figure 2
Figure 2
A) Long-term tracking of LA size in men and B) Long-term tracking of LA size in women with low, intermediate and high risk factor profiles (women and men with a low risk factor profile - black diamond; women and men with an intermediate risk factor profile - black square; women and men with a high risk factor profile - black triangle)
Figure 2
Figure 2
A) Long-term tracking of LA size in men and B) Long-term tracking of LA size in women with low, intermediate and high risk factor profiles (women and men with a low risk factor profile - black diamond; women and men with an intermediate risk factor profile - black square; women and men with a high risk factor profile - black triangle)
See this image and copyright information in PMC

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