Relation of Functional Status to Risk of Development of Atrial Fibrillation

Area of Science:

• Cardiology
• Preventive Medicine
• Geriatrics

Background:

• Identifying individuals at risk for atrial fibrillation (AF) is crucial for implementing preventive strategies.
• Previous research has focused on myocardial dysfunction, but the role of functional capacity requires further investigation.

Purpose of the Study:

• To determine if impaired functional capacity is associated with an increased risk of developing AF, independent of myocardial dysfunction.
• To explore the relationship between exercise capacity and AF risk in older adults with cardiovascular risk factors.

Main Methods:

• A community-based study involving 607 asymptomatic participants aged 65 years and older with at least one cardiovascular risk factor.
• Baseline assessments included echocardiography to measure myocardial mechanics and a six-minute walk test to assess functional capacity.
• The CHARGE-AF score was used to estimate 5-year AF risk, with receiver operating characteristic curves employed to identify independent risk factors.

Main Results:

• Higher AF risk was associated with older age, hypertension, diabetes mellitus, and ischemic heart disease.
• Increased AF risk correlated with lower exercise capacity, independent of echocardiographic measures of myocardial function such as global longitudinal strain, global circumferential strain, E/e' ratio, left atrial volume, and left ventricular mass.
• Multivariate regression analysis confirmed the association between left ventricular function, functional capacity, and AF risk.

Conclusions:

• Poor functional status is an independent risk factor for developing atrial fibrillation.
• The association between impaired functional capacity and AF risk precedes the clinical onset of AF, suggesting its utility in early risk stratification.