Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2014 Jan 2;4(1):e004001.
doi: 10.1136/bmjopen-2013-004001.

Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period: the CARDIA study

Anderson C Armstrong  1 , Samuel S Gidding, Laura A Colangelo, Satoru Kishi, Kiang Liu, Stephen Sidney, Suma Konety, Cora E Lewis, Luís C L Correia, Joao A C Lima
Affiliations
Observational Study

Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period: the CARDIA study

Anderson C Armstrong et al. BMJ Open. .

Abstract

Objectives: We investigate how early adult and 20-year changes in modifiable cardiovascular risk factors (MRF) predict left atrial dimension (LAD) at age 43-55 years.

Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled black and white adults (1985-1986). We included 2903 participants with echocardiography and MRF assessment in follow-up years 5 and 25. At years 5 and 25, LAD was assessed by M-mode echocardiography, then indexed to body surface area (BSA) or height. Blood pressure (BP), body mass index (BMI), heart rate (HR), smoking, alcohol use, diabetes and physical activity were defined as MRF. Associations of MRF with LAD were assessed using multivariable regression adjusted for age, ethnicity, gender and year-5 left atrial (LA) size.

Results: The participants were 30±4 years; 55% white; 44% men. LAD and LAD/height were modest but significantly higher over the follow-up period, but LAD/BSA decreased slightly. Increased baseline and 20-year changes in BP were related to enlargement of LAD and indices. Higher baseline and changes in BMI were also related to higher LAD and LAD/height, but the opposite direction was found for LAD/BSA. Increase in baseline HR was related to lower LAD but not LAD indices, when only baseline covariates were included in the model. However, baseline and 20-year changes in HR were significantly associated to LA size.

Conclusions: In a biracial cohort of young adults, the most robust predictors for LA enlargement over a 20-year follow-up period were higher BP and BMI. However, an inverse direction was found for the relationship between BMI and LAD/BSA. HR showed an inverse relation to LA size.

Keywords: Cardiology; Epidemiology.

PubMed Disclaimer

References

    1. Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440–63 - PubMed
    1. Tops LF, van der Wall EE, Schalij MJ, et al. Multi-modality imaging to assess left atrial size, anatomy and function. Heart 2007;93:1461–70 - PMC - PubMed
    1. Dewey FE, Rosenthal D, Murphy DJ, Jr, et al. Does size matter? Clinical applications of scaling cardiac size and function for body size. Circulation 2008;117:2279–87 - PubMed
    1. Edvardsen T. The continued discovery of left atrial function. Eur Heart J Cardiovasc Imaging 2012;13:203–4 - PubMed
    1. Sidney S, Jacobs DR, Jr, Haskell WL, et al. Comparison of two methods of assessing physical activity in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol 1991;133:1231–45 - PubMed

Publication types

LinkOut - more resources