New-onset left atrial enlargement in a general population

Area of Science:

• Cardiology
• Echocardiography
• Public Health

Background:

• Increased left atrium diameter (LAD) is a significant risk factor for cardiovascular morbidity and mortality.
• Left atrium enlargement (LAE) is associated with adverse cardiovascular outcomes.
• Understanding the progression of LAD to LAE in the general population is crucial for cardiovascular risk assessment.

Purpose of the Study:

• To evaluate the incidence of new-onset left atrium enlargement (LAE) over a 10-year period in a general population sample.
• To identify the correlates and risk factors associated with the development of LAE.
• To determine if home or ambulatory blood pressure measurements offer predictive superiority over office values for LAE.

Main Methods:

• A cohort of 1045 participants with normal baseline LAD underwent echocardiography at baseline and after 10 years.
• Standardized cut-points for abnormal LAD were based on American Society of Echocardiography recommendations.
• Multivariate analysis was used to identify independent correlates of new-onset LAE.

Main Results:

• Over 10 years, 11.8% of participants developed LAE.
• The incidence of new LAE increased with higher tertiles of baseline blood pressure (BP), BMI, fasting blood glucose, and left ventricular mass index (LVMI).
• Independent correlates of new-onset LAE included baseline LAD, female sex, office systolic BP, BMI, and LVMI.

Conclusions:

• Long-term progression from normal LAD to LAE is independently associated with baseline LAD, female sex, BMI, LVMI, and BP.
• Office BP measurements were as predictive as home or ambulatory BP for LAE.
• Preventing elevated BP, overweight/obesity, and left ventricular hypertrophy are key strategies for LAE prevention.