Heart failure & cardiomyopathiesCohort study
Physiological Left Atrial Staging and the Risk of New-Onset Atrial Fibrillation in Hypertrophic Cardiomyopathy
- Retrospective cohort study
- multicentre
- 2 academic referral centres
- external validation cohort
Authors' conclusion
The proposed LA staging framework offers mechanistic insights into how the LA adapts to progressive diastolic dysfunction in HCM. It is associated with a graded risk of NOAF
Study context
- Population
- Consecutive hypertrophic cardiomyopathy (HCM) patients with normal LV systolic function, without valvular heart disease or prior atrial fibrillation (AF), 2007–20241,856 screened
- Participants
- 705 patients
- Exposure
- Left atrium (LA) stages
- Outcome
- New-onset AF (NOAF)
- Follow-up
- Median 7.5 years (Q1-Q3: 3.6-11.0 years)
Main finding
NOAF
Adjusted hazard ratio
1.83
95% CI 1.42–2.37
P < 0.001
Staging system (per increment)
adjusted HR 1.83 (95% CI 1.42–2.37); P < 0.001
Per increment, as printed
As reported in the abstract
- New-onset atrial fibrillation (NOAF) events
- 101
Observational data: associations, not effects.
Further findings
Landmark, competing-risk and external validation analyses
- Consistent results in 1-year landmark, competing-risk analyses and external validation cohort (n = 425)
Serial echocardiography: LA stage evolution · 4 to 6 years after baseline
- Stable
- 39.6%
- Progressed to higher stages or AF
- 43.8%
- 217 patients
Original publication
Physiological Left Atrial Staging and the Risk of New-Onset Atrial Fibrillation in Hypertrophic Cardiomyopathy. J Am Coll Cardiol. Published 27 August 2026. doi:10.1016/j.jacc.2026.08.014
Summarised from the published abstract; every number is checked against it