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Left atrial diameter in nonvalvular atrial fibrillation: An echocardiographic study. Stroke Prevention in Atrial
H C Dittrich1, L A Pearce, R W Asinger
1Statistics and Epidemiology Research Corporation, Seattle, Wash. 98105, USA.
Insights
In patients with nonvalvular atrial fibrillation (AF), left atrial enlargement is common. Age, body weight, and the duration of AF independently predict left atrial diameter.
Area of Science:
- Cardiology
- Echocardiography
- Atrial Fibrillation Research
Background:
- Left atrial (LA) enlargement is common in patients with nonvalvular atrial fibrillation (AF).
- Factors influencing LA diameter in these patients are not fully understood.
Purpose of the Study:
- To identify clinical and echocardiographic factors associated with left atrial diameter in patients with nonvalvular AF.
Main Methods:
- A cohort study of 3465 participants with nonvalvular AF from 3 multicenter clinical trials.
- M-mode echocardiography was used to measure LA diameter.
- Cross-sectional multivariate regression analyses were performed to correlate LA diameter with various features.
Main Results:
- Mean LA diameter was 47 ± 8 mm, significantly larger in those with AF compared to sinus rhythm (48 mm vs 42 mm).
- Patient age and body weight were independent predictors of LA diameter (P <.0001).
- Prolonged AF duration, left ventricular dilatation/hypertrophy, mitral regurgitation, annular calcification, and hypertension also independently predicted LA diameter.
Conclusions:
- Multiple factors contribute to LA enlargement in nonvalvular AF.
- The presence and duration of the atrial fibrillation dysrhythmia are significant contributors to LA size.
Background:
The left atrium (LA) is usually enlarged in patients with nonvalvular atrial fibrillation (AF), but factors associated with LA diameter are incompletely defined.
Methods And Results:
This transthoracic echocardiographic cohort study includes 3465 participants with nonvalvular AF in 3 multicenter clinical trials. LA diameter determined by M-mode echocardiography was correlated with clinical and echocardiographic features by cross-sectional multivariate regression analyses. The mean LA diameter was 47 +/- 8 mm, on average 6 mm larger in those with AF at the time of echocardiography than in those with sinus rhythm (48 vs 42 mm, P <. 001). Patient age and body weight were independently predictive of LA diameter (P <.0001), but sex, body surface area, and body mass index were not. The estimated independent contribution of atrial rhythm to LA diameter was approximately 2.5 mm. Prolonged duration of AF, left ventricular dilatation and increased muscle mass, mitral regurgitation, annular calcification, and hypertension were additional independent predictors of LA diameter.
Conclusions:
Multiple factors appear to contribute to LA enlargement in patients with nonvalvular AF, including the presence and persistence of the dysrhythmia.