Arrhythmias & electrophysiology
Cardiac mechanics and the risk of atrial fibrillation in a community-based cohort of older adults
Authors' conclusion
In a large cohort of older adults without prevalent AF and stroke, measures of LA function improved the prediction of AF more than other conventional cardiac measures.
Study context
- Population
- Older adults without prevalent atrial fibrillation (AF) or stroke in the Atherosclerosis Risk in Communities (ARIC) study, with complete 2D echocardiography incl. Left ventricle (LV) and left atrium (LA) speckle-tracking676 developed AF
- Participants
- 5,050 adults
- Exposure
- Echocardiographic measures added to CHARGE-AF score vs CHARGE-AF score alone
- Outcome
- Incident AF (incl. atrial flutter); improvement in discrimination and risk classification vs CHARGE-AF score
- Follow-up
- Median 7 years
Methodological detailscommunity-based
- Community-based
Main finding
As reported in the abstract
Risk discrimination of incident AF
| Outcome | CHARGE-AF | LA reservoir strain | LA contraction strain | LA minimal volume index |
|---|---|---|---|---|
| Risk discrimination of incident AFC-statistic | 0.68 (95% CI 0.65–0.70) | 0.73 (95% CI 0.70–0.75) | 0.72 (95% CI 0.70–0.75) | 0.72 (95% CI 0.69–0.75) |
| Category-based NRI | — not stated in the abstract | 29% | 24% | 20% |
— not stated in the abstract
Observational data: associations, not effects.
Further findings
AF incidence (whole cohort) · median follow-up 7 years
- Incidence rate
- 2.13 per 100 person-years
- Participants developing AF
- 676
Association of cardiac measures with incident AF
- LV mass index and wall thickness, E/e', and LA structure and function measures associated with incident AF, but not LV systolic function (confounder-adjusted)
Original publication
Cardiac mechanics and the risk of atrial fibrillation in a community-based cohort of older adults. Eur Heart J Cardiovasc Imaging. Published 3 July 2024. doi:10.
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