Heart failure & cardiomyopathies
Change in left atrial function and volume predicts incident heart failure with preserved and reduced ejection fraction: Multi-Ethnic Study of Atherosclerosis
Authors' conclusion
ΔLASmax and ΔLAVipreA were associated with and incrementally predictive of HFpEF and HFrEF, after adjusting for risk factors and baseline LA measures in this population of subclinical CVD.
Study context
- Population
- Multi-ethnic adults free of clinical cardiovascular disease (CVD) at baseline (subclinical CVD), MESA73 incident heart failure (HF)
- Participants
- 2,470 adults
- Exposure
- Change in left atrial (LA) strain and volume vs incident HF with preserved ejection fraction (HFpEF) and HFrEF
- Outcome
- Incident HF (HFpEF and HFrEF)
- Follow-up
- 7.1 ± 2.1 years after the second study
Methodological detailsmulti-ethnic, cardiac magnetic resonance (CMR) at baseline (2000-02) and second study 9.4 ± 0.6 years later
- Multi-ethnic
- CMR at baseline (2000-02) and second study 9.4 ± 0.6 years later
Main finding
As reported in the abstract
- Incident HFpEF
- n = 39
- Incident HFrEF
- n = 34
- Annual 1 SD decrease in peak LA strain (ΔLASmax) and HFpEF: subdistribution HR (95% CI 1.34-4.90), P = 0.004
- 2.56
- ΔLASmax predicting HFpEF: C-statistic
- 0.84 (95% CI 0.79-0.90)
- ΔLASmax predicting HFpEF: Net reclassification index (NRI), P = 0.01
- 0.34
- Annual 1 mL/m² decrease in pre-atrial indexed LA volume (ΔLAVipreA) and HFrEF: subdistribution HR (95% CI 1.44-2.45), P < 0.001
- 1.88
- ΔLAVipreA predicting HFrEF: C-statistic
- 0.81 (95% CI 0.72-0.90)
- ΔLAVipreA predicting HFrEF: NRI, P = 0.03
- 0.31
- ΔLAVipreA predicting HFrEF: Integrated discrimination index (IDI), P = 0.50
- 0.01
Observational data: associations, not effects.
Original publication
Change in left atrial function and volume predicts incident heart failure with preserved and reduced ejection fraction: Multi-Ethnic Study of Atherosclerosis. Eur Heart J Cardiovasc Imaging. Published 17 June 2024. doi:10.
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