Arrhythmias & electrophysiology

Early life and adulthood risk factors for middle age P -wave prolongation and left atrial enlargement

Eur J Prev CardiolPublished Prospective cohort study

Authors' conclusion

Excess BMI from childhood through adulthood is a key determinant of atrial remodelling in middle age.

Study context

Population
Participants of the Cardiovascular Risk in Young Finns Study, risk factors assessed 1980–2001 (ages 6–24 years), echocardiography and ECG in 2011
Exposure
Cumulative early life CV risk factors (ages 6-24 years) and P-wave duration and left atrial (LA) size in middle age
Outcome
P-wave duration, LA diameter and LA volume
Follow-up
Middle age (2011)
Methodological detailsmulticentre
  • Multicentre

Main finding

As reported in the abstract

Longer P-wave duration per SD increase in early life body mass index (BMI) burden

0.120 SD; 1.85 ms

Larger LA diameter per SD increase in early life BMI burden

0.264 SD; 0.11 cm

Greater LA volume per SD increase in early life BMI burden

0.235 SD; 3.31 mL

Observational data: associations, not effects.

Further findings

Other determinants

Higher physical activity in middle age associated with increased LA volume
0.116 SD (1.64 mL)
Male sex associated with all studied P-wave and LA parameters
Older age associated with larger LA diameter
Persistent or adult-onset high BMI more likely to have larger LA

Original publication

Early life and adulthood risk factors for middle age P -wave prolongation and left atrial enlargement. Eur J Prev Cardiol. Published 24 July 2026. doi:10.1093/eurjpc/zwag366

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