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Published on: July 20, 2022
Small Left Ventricle in Patients With Atrial Fibrillation Is Associated With Increased Cardiovascular Risk
Mingxiao Li1, Lan Ren1, Liu He1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Insights
Small left ventricle (LV) size is linked to higher cardiovascular event risk in atrial fibrillation (AF) patients. This finding is crucial for risk stratification and managing AF patients with small LVs.
Area of Science:
- Cardiology
- Echocardiography
- Clinical Research
Background:
- The prognostic significance of a small left ventricle (LV) in patients with atrial fibrillation (AF) remains uncertain.
- Investigating LV size as a potential adverse structural predictor in AF is essential for improving patient outcomes.
Purpose of the Study:
- To determine the association between small LV size and the risk of major cardiovascular events in a large AF cohort.
- To analyze the relationship between left ventricular end-diastolic dimension (LVEDD) and cardiovascular outcomes.
Main Methods:
- Utilized data from the China-AF registry, enrolling 7,764 AF patients.
- Classified LV size into normal, small, and large groups based on LVEDD measurements.
- Employed Cox regression models to assess the risk of composite cardiovascular events (cardiovascular death, stroke, embolism, major bleeding).
Main Results:
- Small LV was observed in 4.0% of patients and was independently associated with increased risk of composite cardiovascular events (aHR: 1.54) and cardiovascular death (aHR: 1.94).
- Small LV also correlated with a higher risk of major bleeding (aHR: 2.21).
- A significant U-shaped relationship was found between LVEDD and composite cardiovascular events (P<0.001).
Conclusions:
- Small LV is an independent predictor of increased cardiovascular event risk in patients with AF.
- These findings highlight the importance of considering LV size in the risk stratification and management strategies for AF patients.
- The study underscores the prognostic value of LV dimensions in AF.
Background:
It is still unclear whether small left ventricle (LV) is an adverse structural prognostic feature in patients with atrial fibrillation (AF).
Objectives:
The purpose of this study was to evaluate the association between small LV and risk of cardiovascular events in AF population.
Methods:
From the China-AF registry, 7,764 patients with AF were enrolled and divided into groups with normal, small, and large LV size based on left ventricular end-diastolic dimension (LVEDD) measurement per the American Society of Echocardiography references. Cox models were used to assess the association between LV size or LVEDD with composite cardiovascular events (cardiovascular death, ischemic stroke or systemic embolism, or major bleeding).
Results:
There were 308 (4.0%) participants assessed with small LV who were older, with lower body mass and blood pressure, and fewer comorbidities, and 429 (5.5%) were identified with large LV. Compared with the normal LV group, small LV and large LV were significantly associated with higher incidence of composite cardiovascular events (adjusted HR [aHR]: 1.54 [95% CI: 1.07-2.20] for small LV; aHR: 1.36 [95% CI: 1.02-1.81] for large LV) and cardiovascular death (aHR: 1.94 [95% CI: 1.14-3.28] for small LV; aHR: 1.83 [95% CI: 1.24-2.69] for large LV). Small LV was also associated with increased risk of major bleeding [aHR: 2.21 [95% CI: 1.01-4.86]). A U-shaped relationship between LVEDD and composite cardiovascular events was identified (Pnonlinear < 0.001).
Conclusions:
In a prospective AF cohort, small LV was independently associated with an increased risk of cardiovascular events, which needed consideration in risk stratification and management for patients with AF. (ChiCTR-OCH-13003729).
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