Arrhythmias & electrophysiology
Right and Left Atrial Dysfunction as Independent Cardiovascular Risk Factors: A UK Biobank Study
Authors' conclusion
In this largest assessment of biatrial structure and function to date, both left and right atrial cardiopathies were independently associated with increased risk of adverse cardiovascular events. We identified several novel genetic loci for atrial traits and observed unique genetic correlations between left and right atrial traits and cardiovascular phenotypes, providing insight into chamber-specific remodeling. Several of these measures are likely to be causal determinants of cardiovascular complications previously attributed to AF.
Study context
- Population
- UK Biobank participants without prevalent atrial fibrillation (AF)UK Biobank participants without prevalent AF
- Participants
- 51,693 participants
- Comparison
- Associations of biatrial volumes and emptying fraction with new-onset AF, ischemic stroke, heart failure, and dementia
- Outcome
- Incident events:
- AF
- Ischemic stroke
- Heart failure
- Dementia
- Follow-up
- 4-year follow-up
Methodological detailscardiac magnetic resonance imaging using deep learning segmentation, genome-wide association study, Mendelian randomization
- Cardiac magnetic resonance imaging using deep learning segmentation
- Genome-wide association study
- Mendelian randomization
Main finding
As reported in the abstract
Developed AF
964
1.9%
Developed ischemic stroke
266
0.5%
Developed heart failure
365
0.7%
Developed dementia
72
0.1%
Further findings
New-onset AF by left atrial minimal volume
| Hazard ratio (95% CI) | ||
|---|---|---|
| Left atrial minimal volumeAfter adjustment for clinical risk factors | 1.55 (1.48–1.62) | |
| 0.512Hazard ratio (log scale) |
- Both left and right atrial measures associated with new-onset AF, ischemic stroke, and heart failure, with stronger associations in women
- Left atrial minimal volume also associated with dementia
Genome-wide association study
- Genetic associations with atrial measures
- 51 (27 novel)
- Each atrium had varying correlations with cardiometabolic risk factors
Mendelian randomization
- Left atrial measures had direct causal effects on AF and stroke risk
- Stroke associations attenuated after accounting for AF variants
Original publication
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