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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Left Atrial Function and Incident Heart Failure in Older Adults
Carlo Mannina1, Kazato Ito2, Zhezhen Jin3
1Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Summary
Left atrial coupling index predicts heart failure development in older adults. This measure is a stronger predictor than left atrial volumes and strain, improving risk assessment.
Area of Science:
- Cardiology
- Geriatrics
- Echocardiography
Background:
- Heart failure (HF) is increasingly prevalent, particularly in older populations.
- Left atrial (LA) dysfunction is linked to HF, but its predictive role in HF development is not fully understood.
- This study examines LA function's ability to predict new-onset HF in elderly individuals without prior cardiovascular events.
Purpose of the Study:
- To determine if measures of left atrial (LA) function can predict the incidence of heart failure (HF) in adults aged 55 and older.
- To compare the predictive power of various LA functional parameters, including volumes, strain, stiffness, and the LA coupling index (LACI), for incident HF.
- To assess the independent predictive value of LA function for HF development, adjusting for established cardiovascular risk factors.
Main Methods:
- A cohort of 795 adults aged ≥55 without prior cardiovascular events was studied.
- Echocardiography (standard, 3D, speckle-tracking) was used to measure LA volumes, strain, stiffness, and LACI.
- Participants were followed for a mean of 11.4 years for new-onset HF, with ascertainment via interviews, visits, and hospital record surveillance.
Main Results:
- New-onset HF occurred in 43.4% of participants during follow-up.
- All assessed LA morphology and function measures were associated with incident HF (P < .05).
- In multivariable analysis, LA stiffness and LACI were independently associated with incident HF. After adjusting for left ventricular global longitudinal strain, only LACI remained a significant predictor.
Conclusions:
- The Left Atrial Coupling Index (LACI) is a significant independent predictor of incident heart failure in older adults.
- LACI demonstrates superior predictive capability for HF development compared to traditional LA volume and strain measurements.
- Incorporating LACI into risk assessment models may enhance the stratification of HF risk in the elderly population.
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